Episiotomies are NOT Necessary
Then why are rates at 99% for vaginal births in hospitals?
When a baby is stuck (in the birth canal) during childbirth, it is not necessary to cut a woman (episiotomy) in order to have a safe delivery according to American researchers on birthing techniques. It is more effective and desirable to maneuver the baby than carrying out an episiotomy. According to researchers at John Hopkins University, ‘an episiotomy does not reduce the infant's risk of shoulder injury at all. In fact, the risk may be increased.’
Dr Edith Gurewitsch and colleagues examined the medical records of 127 cases where delivering the baby's shoulders was difficult. Nerve damage rates to the delivered babies in these 127 cases were no better if the mother was given an episiotomy. Maneuvering alone was 35% safer for the baby's shoulder, and much better for the mothers. The research team believes an episiotomy should only be carried out when it is absolutely necessary. "Episiotomy will only eliminate soft tissue barriers to delivery, whereas rotating the infant will realign its shoulders to fit within the mother's pelvis. It is the bony pelvis that is widely acknowledged as the main cause for the infant getting caught in the birth canal," she said.
Episiotomies are very unpleasant and sometimes dangerous for the mother as she is at a much higher risk of developing an infection, bleeding and having pelvic floor disorders. A mother may suffer long term pain or discomfort during sexual intercourse. She can experience urinary incontinence or flatulence. Urinary incontinence is the involuntary leakage of urine; in simple terms, to pee when you don't intend to. It is the inability to hold urine in the bladder because voluntary control over the urinary sphincter is either lost weakened and flatulence.
The doctors at John Hopkins University said maneuvering is better for the baby as it suffers fewer shoulder injuries. The benefits for the mother are obvious as she does not experience unnecessary trauma.
Then why are unofficial episiotomy rates in hospitals 99% for vaginal births? It is because guidelines recommend an episiotomy is performed to benefit the doctor as it gives the doctor more room to maneuver the baby. Doctors normally reason that the procedure is to “prevent perineum tears” however such tears are normal and will heal faster than an unnatural cut and normally without extended complications. It is of no benefit to the delivery of the baby.
In your Birth Plan remember to include whether or not you prefer to have an episiotomy in an emergency situation and discuss it in detail with your doctor. Ask your doctor for his/her personal rates of episiotomies and the hospital rates. Ask him/her what they normally do in a situation when a baby gets stuck. Keep in mind that your doctor may not have much experience in maneuvering babies and an episiotomy may be the first choice of procedure in any emergency.
Whatever decision your make sure you are comfortable and know what will happen in the labor room.
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