Health care providers should cut out painful procedure during birth

Rates of episiotomy being practiced during childbirth are high, despite recommendations by prominent obstetric, midwifery, and nursing bodies to restrict the use of this procedure.

Dr. Ian Graham, a leading researcher on the topic, and his team studied rates of episiotomy around the world. They discovered that episiotomy rates vary by country as well by region. The data showed overall high rates of episiotomy, with the highest rates often found in parts of South and Central America and Asia . Among English-speaking countries, the rate is highest in the US , although there is a decreasing trend.

Rates range from as low as 9.7% in Sweden to 100% in Taiwan. In the United States, rates vary by region where in the Northeast, 38% of deliveries used episiotomy, but in the West only 27% used the practice. Rates also vary by provider within the same institutional system. A previous study in England found a large variance among midwives in the same hospital, suggesting that providers are not being guided solely by clinical indications and guidelines recommending the restrictive use of episiotomy.

Episiotomy, an invasive procedure which involves cutting a woman’s birth canal at the time of delivery, has long been thought to be beneficial because it can facilitate birth, prevent perineal trauma, prevent urinary incontinence later in life, and be less painful than experiencing a spontaneous perineal tear or laceration. However, over the last two decades, research has shown that avoiding episiotomy can mean less perineal trauma, less need for suturing, and fewer complications postpartum.

From Blackwell Publishing

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