The benefits and risks of episiotomy are very disproportionate. When compared together, the research supports that routine episiotomy should be banished as a practice of the past. Even ACOG's position on episiotomy is that the research does not support its routine use.
To widen the perineal opening for the baby's head and prevent tearing.
Episiotomy cuts through muscle tissue as well as skin, which often lead to urinary incontinence. It is also linked with creating more perineal trauma and is actually the cause of additional perineal tearing. Local anesthetics given with episiotomies will cause the perineal tissues to swell, decreasing their flexibility and increasing the chance of a tear. Tears actually heal better than episiotomies. With proper perineal support, both tearing and episiotomy can be avoided. Over 1 million unnecessary episiotomies are performed each year.
a. Can allow the baby to be born more quickly when in distress
a. Damages muscle tissue
b. Can cause tearing in addition to the episiotomy
c. Can lead to urinary incontinence
d. Local anesthetics can cause more tearing by swelling tissues
e. Is usually done for convenience
f. Is usually completely unnecessary
g. Take a long time to heal
h. Requires stitching
i. Increases recovery time
j. Very uncomfortable
k. Episiotomy scar tissue can be inflexible and affect future birthings
Routine episiotomy is not an evidence-based practice. Despite the evidence that the benefits and risks of episiotomy are not justified, some obstetricians persist in using it routinely for convenience, to finish the delivery more quickly. In other cases, some obstetricians believe that all first-time mothers will require an episiotomy, to the detriment of their patients.
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