What Is An Episiotomy?
An episiotomy according to the Random House Unabridged Dictionary, it is an incision into the perineum and vagina to allow sufficient clearance for birth.
It is an incision from vagina to rectum (typically), which allows for an easier delivery, and lessens the chance of a woman’s vagina tearing while giving birth. Are They Safe?An episiotomy is not dangerous to the baby, but it can be for the mother. A woman who is cut while giving birth does not have a shorter labor, as once suspected, and she is also more at risk for:
*increased blood loss
*increased chance of infection
*increased chance of fecal and urinary incontinence
*increased perineal pain after delivery Episiotomy’s used to be a fairly common practice because doctors felt the mother would be spared the agony of having her vagina tear, while the baby would do better because the pressure from the birth canal would be significantly reduced. They know now that this is not the case. A baby born with an episiotomy has no health benefit over a baby born without one, and a woman given an episiotomy has no real benefit over a woman who rips while giving birth. The only real benefit to a woman who has a healthy, average sized baby who has an episiotomy is that when a woman tears it is typically in a zigzag pattern and can be difficult to stitch up, while a woman who is cut would have a nice clean stitch. Reasons For Needing An EpisiotomyThere are only a few medical reasons a woman would absolutely have to have an episiotomy, and they are as follows:
*The baby is too large
*If forceps or vacuum are being performed
*Shoulder dystocia, when the shoulders get stuck in birth canal The Different TypesMedian incision: it is made directly back toward the rectum and is not commonly practiced in the U.S. because the woman has a greater chance of having it rip completely to the rectum.Mediolateral incision:it goes away from the rectum, and is commonly used in first time moms. When During Labor and Delivery Do You Get One?The doctor or midwife performing the procedure will wait until you have a labor contraction because the pressure from the head of the baby has a natural numbing effect on the perineal area. This way if you have not had an epidural you will not be in agonizing pain.How To Reduce The Risk of Needing OneThere are 2 main ways you can reduce your risk of needing one while giving birth.*Kegel exercises throughout pregnancy
*Perineal massage during the last trimester
Your doctor or midwife will most likely massage the area, helping it to stretch out during delivery. This is becoming more and more common, and extremely effective.
It's a routine procedure, but episiotomy provides no benefits. This is the conclusion of a systematic review of existing studies published in the May 4, 2005, edition of the Journal of the American Medical Association (JAMA).
Episiotomy has been a common obstetrical practice since the 1930s. Today, the procedure is performed in up to 35 percent of US vaginal births; 70 to 80 percent of first-time mothers have one done. Yet studies since the 1980s have failed to show any benefit from the procedure. In fact, the researchers of the JAMA article found that in some cases, routine use of episiotomy causes more harm to mothers than avoiding it.
In routine births, women without episiotomies were found to have less pain with faster resolution, and no greater or lesser risk of complications in wound healing. In addition, the evidence showed that episiotomy did not protect women against urinary or fecal incontinence or pelvic-organ prolapse in the first three months to five years following delivery.
"The literature we reviewed suggests that the outcomes with spontaneous tears, if they happen, are better than with episiotomy," said Dr. Katherine Hartmann, lead author of the JAMA article. She noted that women are more likely to suffer the most severe types of tears, from the vagina into the rectum, when they have an episiotomy. Hartmann is assistant professor of obstetrics and gynecology at the University of North Carolina (UNC), Chapel Hill, School of Medicine, and of epidemiology in UNC's School of Public Health. She also directs UNC's Center for Women's Health Research. The report's coauthor, Dr. Meera Viswanathan, senior health analyst at RTI International, concludes that any possible benefits of the procedure do not outweigh the fact that many women would have had less injury without the surgical incision.
The JAMA article is based on work by a team of researchers from the RTI International--UNC Evidence-based Practice Center (EPC), working under contract to the Agency for Healthcare Research and Quality.
Katherine Hartmann, MD, PhD, and Meera Viswanathan, PhD, et al., "Outcomes of Routine Episiotomy," JAMA 293, no. 17 (4 May 2005): 2141-2148.
Bibliography for "Episiotomy doesn't make the cut"
"Episiotomy doesn't make the cut". Mothering. July-August 2005. FindArticles.com. 20 Oct. 2006. http://www.findarticles.com/p/articles/mi_m0838/is_131/ai_n14810498
***Keep in mind, the advice we are giving here is instructional only, we are not medical professionals, and this is for healthy women with normal pregnancies. If you are a high risk pregnancy, or have medical problems, this would not apply to you.
|
Breastfeeding |
Inducing
Labor Naturally |
Trying to
Conceive |
Diet | | Home Pregnancy Tests | Am I Pregnant? | Announcements | | Maternity Clothes | Hospital List | Holistic | | Baby Shower Ideas | Work from Home |
|
