Re: Re Episiotomy competencies

[Christina & Damien]

Hi Jane, I can't help you formally Jane, except to say that I rarely perform episiotomies - about 6 or 7 in 12 years,  but I KNOW that when the situation arises I feel PERFECTLY confident and able to perform the procedure with or without infiltration with local. I feel happy that those cuts I have made have been with maternal consent and with purpose. Surely we shouldn't be expected to do them just to prove we can!!?? P. S. I infiltrated prior to episiotomy on Wednesday, Multiparous woman, labouring well, head on view for about 25 mins, Just prior to infiltration, Fetal Heart on 94, staying there..... progress of head on view had been very slow. Once filtration occurred, head born on next contraction!! I suspect women had been "holding back" due to pain and once the area was numbed she had the will to push through it. Babe's shoulders/body eventually born with difficulty , the most downward traction (woman on all fours on floor) , movement of legs &  thigh I've ever had to help with, but eventually born beautifully and with firm, consistent, downward force.  Anyway, back to the original subject, even though I perform episiotomies infrequently, I don't think that I should have to perform a quota to prove I can do it. It is part of our basic training, much like coating the lips with lip balm, wiping the brow, listening to a fetal heart, education re: breastfeeding. Do we have to prove competancies of these.  Our job is wide, exciting, varied and important. The term "MIDWIFE" encompases this and we should not have to prove such intracacies of our job. I love Midwifery! Christina.      xxxx -----Original Message----- From: cjknight <[EMAIL PROTECTED]> To: [EMAIL PROTECTED] <[EMAIL PROTECTED]> Date: Tuesday, 16 October 2001 9:58 Subject: Re Episiotomy competencies Dear Listers Can anyone help me with some statistics  regarding how many student midwives complete their education without performing an episiotomy? I was unable to gain that competency during my education and there have been few opportunities to gain competency in my current practice despite being in my current position 7 years. I work in low risk midwifery based in a rural hospital. My practice is being called into question over this matter so it is important that I get hold of some evidence to back up my assertion that this is not an uncommon situation. Thanks Jane