Re: [ozmidwifery] 3rd degree tears

[Anne Clarke]

Dear Sue,   Hope you don't mind if I ask you when you do your research could you please share this with us all.  It would be useful to have this information for all.   Regards Anne Clarke ----- Original Message ----- From: Sue Cookson To: ozmidwifery@acegraphics.com.au Sent: Monday, August 29, 2005 6:52 PM Subject: Re: [ozmidwifery] 3rd degree tears Hi again, I also forgot to add that the nurse practitioner also stated that an episiotomy rate of 10-15% for birth was justified and there was only 'soft evidence' for promoting tears over episiotomies. I do fully intend to follow this with a research search. For those of you who have commented about intact perineums and home births and birth centres and ways of delivering heads slowly etc - she is maintaining that all those categories have hidden or closed 3rd degree tears. I did enter into a discussion with her about the benefits of well informed women birthing heads consciously (the women I see all read particular articles, watch videos and we talk talk talk about slowly letting the head through...), but what research do I have to give to her to point out the evidence-based evidence for this?? This is certainly highlighting the need for eidence-based information to be very carefully examined, which I will do and will share my findings. Sue Hi, I've just returned from a clinical placement in SA where I spent a mindblowing three hours in an incontinence clinic in an outpatients unit at a major hospital. The mindblowing element was the following statistics (copied from one of the handouts): 39-49% women tear or have an episiotomy needing sutures 0.5 - 2.5% have a 3rd or 4th degree tear after vaginal childbirth that is visible 25-35% after first vaginal delivery have a concealed or closed 3rd degree tear, not visible Listed as contributing factors were: 1st vaginal birth forceps/instrumental delivery long second stage  >1 hour big baby    >4kgs tissue type, short perineum, epidural, uncontrolled pushing, rapid delivery, midline tear or episiotomy The nurse practitioner stated this was all evidence-based information and recommended c/sections to women who had had previous 3rd degree repairs - these were the ones who knew about their tears obviously. The handouts do not give references and as yet I have not had time to begin researching. Are you all as mindblown as I am?? What do you think - are 1/4 - 1/3 of us walking around with damaged anal sphincters and not aware of it?? Where does this sort of information lead us - if our bodies are so inept at giving birth then all first babies and subsequently all babies should be born by c/section. Sue __________ NOD32 1.1203 (20050827) Information __________ This message was checked by NOD32 antivirus system. http://www.nod32.com __________ NOD32 1.1203 (20050827) Information __________ This message was checked by NOD32 antivirus system. http://www.eset.com