What kind of participant input are you looking for. I had an episiotomy with my first child (under obs care) then none in my subsequent three births and no tearing either. The explanation I got about epis. was very different from obs to midwives (surprise surprise) In a nutshell obs scared the daylights out of me with horror outcomes if I would tear as opposed to the benefits of a cut. Midwives were very concerned about getting babies out without tearing or cutting, but explained that a tear is better in the long run. feel free to email me offline.
Kylie Carberry
From: Belinda <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] episi research
Date: Thu, 03 Nov 2005 12:31:37 +1030
>
>A huge part of women's view is the language used around tearing and
>episiotomy and the lack of positive language for womens vagina in
>birth, ie capacity to stretch and recover. I see the language around
>tearing such as mutilating uncontrolled etc whereas episis are seen
>as controlled, neat straight etc. In a society where we trust
>surgery so much - just look at the cesarean section rates - episi
>fits into this. In classes i teach women to think about the capacity
>of their vaginas and perineums in birth and find positive ways of
>discussing this. I also talk about tearing along a muscle line as
>more able to heal well than a cut through it. I always say it may be
>easier for me to suture an episiotomy but I am not the one who has
>to sit on it and feel it for the rest of my life - so it should
>never be about what is good for the perosn managing the birth
>(although unfortunalty it most often is). It is inetresting that
>people always ask well can I say no, why do they think someone else
>has the right to cut into their vaginas when there is no research to
>support this as a routine practive!!! Any way I could go on for ever
>about this issue...
>I am finishing my Phd at the moment and have just cut out a chapter
>looking at womens worries around their vaginas in birth and a
>feminist discussion around episis etc, I found my other chapters
>were big enough and the women in my study didnt really talk much
>about worrys of tearing.
>I wonder why you are having trouble recruiting, i am happy to chat
>to you off line about this
>it is great to see this type of research being done
>Belinda
>
>Alice Morgan wrote:
>
>>
>>This is interesting for me. I am currently writing my midwifery
>>honours thesis on women's views about episiotomy (or trying to at
>>least, unfortunately I am having great difficulty with participant
>>recruitment). It's always nice to see more research backing up what
>>I am saying.
>>
>>:) Alice (one of the first SA BMid grduate midwives)
>>
>>
>>>From: "leanne wynne" <[EMAIL PROTECTED]>
>>>Reply-To: ozmidwifery@acegraphics.com.au
>>>To: ozmidwifery@acegraphics.com.au
>>>Subject: [ozmidwifery] article FYI
>>>Date: Wed, 02 Nov 2005 11:05:02 +1100
>>>
>>>Unnecessary episiotomies
>>>Issue 22: 31 Oct 2005
>>>Source: International Journal of Gynecology & Obstetrics 2005; 91:
>>>157-9
>>>
>>>Researchers have questioned the continuing widespread use of
>>>routine episiotomy, after finding high rates at some centres in
>>>countries in South America, Asia, and Africa.
>>>
>>>Systematic reviews of published trials, including a Cochrane
>>>review, have suggested that episiotomies should not be performed
>>>routinely, because of the associated maternal morbidity.
>>>
>>>Some specialists have said that no more than 10 percent of
>>>nulliparous women delivering vaginally should need one, according
>>>to the researchers writing in the latest issue of the
>>>International Journal of Gynecology & Obstetrics.
>>>
>>>But their study suggests that episiotomy rates are far higher than
>>>this at some hospitals. The researchers, from Uruguay and the USA,
>>>analyzed data on episiotomy rates for nulliparous and multiparous
>>>women at hospitals in Argentina, Brazil, Bolivia, Chile, the
>>>Democratic Republic of Congo, Ecuador, India, Tibet, Uruguay,
>>>Venezuela, and Zambia.
>>>
>>>The hospitals studied (from 1 to 13 per country) were part of the
>>>US National Institute of Child Health and Human Developments
>>>Global Network for Womens and Childrens Health Research.
>>>
>>>Rates above 90 percent
>>>Reporting their findings, the researchers say that episiotomy
>>>rates among nulliparous women were higher than 90 percent in all
>>>countries except Zambia (6.9 percent).
>>>
>>>Episiotomy rates for all vaginal births were higher than 20
>>>percent in all countries except Zambia, and were as high as 80
>>>percent in Brazil. The exception, Zambia, was unusual in having a
>>>lower rate for nulliparous women than for all vaginal births. The
>>>researchers, however, caution that the data for Zambia were
>>>obtained from only one hospital.
>>>
>>>They also advise against generalizing the findings beyond the
>>>centres studied. However, they say the data illustrate the
>>>widespread use of routine episiotomy in contradiction to the
>>>evidence questioning its efficacy.
>>>
>>>Unnecessary episiotomies, the researchers write, increase the risk
>>>of morbidity as indicated by the Cochrane review, including
>>>posterior perineal trauma, the need for suturing the perineal
>>>wound, and healing complications at 7 days.
>>>
>>>They conclude: Strategies should be developed to decrease
>>>episiotomy rates at a global level.
>>>
>>>
>>>
>>>Leanne Wynne
>>>Midwife in charge of "Women's Business"
>>>Mildura Aboriginal Health Service Mob 0418 371862
>>>
>>>
>>>--
>>>This mailing list is sponsored by ACE Graphics.
>>>Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
>>
>>
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