If you're going to go into labour soon, chances are that you may have to have an episiotomy. An episiotomy is an incision made in the perineum to enlarge the opening during birth. It can also prevent any tears that may occur during labour. While small tears aren't a big worry, severe tears can cause health problems that might not ever be fully resolved.
In more recent years, routine episiotomies became less popular due to the new belief that they're unnecessary medical interventions. They've also been seen as increasing pain and causing longer recovery time for women who've given birth. Yet a new study has revealed that shunning episiotomies during labour and delivery may be hurting a lot of pregnant women.
For this study, researchers looked at data from 2.57 million vaginal deliveries between April of 2004 to March of 2018. So-called "spontaneous deliveries"- where either forceps or a vacuum aren't used- were compared to deliveries were one of those devices had to be used. Episiotomies were found to happen in both forceps and vacuum-assisted deliveries. They were used in 65 percent of forceps-assisted deliveries, in 38 percent of vacuum-assisted deliveries, and 68 of deliveries where both had been used.
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In addition to the aforementioned situations, there are more scenarios where an episiotomy had happened. This includes fetal distress, if the woman had an epidural, if the woman is having a larger baby, older pregnant women and/or prolonged labour. Such situations were found to call for an episiotomy in order for the baby to be successfully born. Episiotomies were associated with a higher rate of anal sphincter injuries among women who had had spontaneous vaginal deliveries. The rate is 4.8 percent when compared to the 2.4 percent of women who didn't have an episiotomy during labour.
But for women who were giving birth for the very first time and needed forceps or had a vaginal birth after a prior c-section, episiotomies brought on a lower rate of severe tears. For women who gave birth for the first time with forceps, 18.7 percent who had an episiotomy had a perineal injury when compared to 28.4 percent who didn’t have one. 12.7 percent of women giving birth for the first time with the assistance of a vacuum with an episiotomy had such injuries, and 13.8 percent who didn’t have one had such injuries. In first-time deliveries where both forceps and a vacuum were utilized, 33.8 percent of women who didn't have an episiotomy had injuries when compared to the 24.4 percent who did.
It's believed that shunning episiotomies anymore is a bad idea because they can help women who are giving birth. They can help get the baby out easier and can make it even easier when used with forceps and/or a vacuum. That matters because, at the end of the day, episiotomies make delivery better for both mother and baby. The mother has fewer injuries from giving birth, and the baby's born faster and easier. That's a solid win-win!