RE: [ozmidwifery] when to cut an episiotomy

[Lieve Huybrechts]

Title: Bericht

Hoi Païvi,   This was on  the list a while ago.   greetings Lieve     Routine episiotomy shows no benefits, only harm Source: Journal of the American Medical Association 2005; 293: 2141-8 Comparing maternal outcomes with routine versus restrictive use of episiotomy in a systematic review of the literature. Routine episiotomy does not appear to provide the benefits traditionally credited to it, and, in some cases, is more damaging than a spontaneous tear, say researchers. Episiotomy was initially introduced on the assumption that a deliberate incision would heal more quickly and with fewer complications than a spontaneous tear, and that it would lead to less pelvic floor problems, such as fecal or urinary incontinence or impaired sexual function, later on. To determine whether this is actually the case, researchers led by Katherine Hartmann, from the University of North Carolina at Chapel Hill in the USA, conducted a systematic review of the best quality trials available comparing routine with restrictive use of the procedure. The 26 articles selected for detailed study were consistent in finding that routine episiotomy did not reduce the severity of laceration, pain, or pain medication use, compared with restricted surgery. There was also no evidence to support the longer-term outcomes ascribed to episiotomy, including prevention of fecal or urinary incontinence or reduced impaired sexual function. In fact, pain during intercourse was more common in women who underwent the procedure. Study co-author John Thorp Jr. summarized: "In most cases, episiotomy doesn't do any good, and it can harm women. Why would one want a surgical procedure that's worthless     Lieve Huybrechts vroedvrouw 0477/740853 -----Oorspronkelijk bericht----- Van: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Namens Päivi Verzonden: zondag 21 augustus 2005 10:31 Aan: ozmidwifery@acegraphics.com.au Onderwerp: [ozmidwifery] when to cut an episiotomy A mom asked me when is episiotomy really needed. She had asked from many professionals, and all just gave her the answer, that "They will try to avoid episiotomy, but will cut just in case, if not sure". In Finland the episiotomy rates are from 4% to 50%, and for firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will know best. (That is a medicalaized hospital midwife in most cases). I already know, that you have a different opinion on  when it is needed, but it would be interesting to know from you, who work as midwifes, how often have you performed episiotomies? Does anyone know, what is the national average in the Australian hospitals?   Paivi -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.10.13/78 - Release Date: 19/08/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.10.13/78 - Release Date: 19/08/2005