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Episiotomies: History, Evidence and Current Practices
Manage episode 438953374 series 3586469
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For the last 60-80 years an incision in the vaginal opening to help the baby come up has been used routinely, with some experts stating, there is no reason not to, so don’t even worry about it!
Yeah.. that was Dr Diethelm specifically, in 1938. Speeding up the pushing stage, helping mom out after pushing for a long time, worrying about the baby being held inside by the tight perineum, trying to avoid major tears by giving a smaller incision, all in the hopes to help out.
Medical and surgical interventions became popular in the 1920s as deliveries moved to the hospital, of course! Most with the best intentions in mind. They thought of a great idea, to use this procedure on everyone and with the help of forceps, totally eliminating the mom from having to push at all! Thanks!
But has the actual evidence held up this theory? Well get into it today! Take what you’ve learned and start the conversation with your provider, remember knowledge is power! Stay informed and stay healthy!
In this episode of the Birth Link Podcast, Colette discusses the topic of episiotomies in detail to help you navigate episiotomies for an empowered birth experience.
00:00 Introduction and Personal Update
00:13 Exciting New Ventures in Maternal and Newborn Care
01:42 The Importance of Birth Plans and Privacy
02:02 Hospital Experiences and Challenges
04:30 Protecting Your Space During Labor
05:37 Introduction to Episiotomies
07:07 History and Evolution of Episiotomies
14:20 Medical Perspectives and Practices
21:29 Conflicting Evidence and Modern Views
23:02 Episiotomy Risks and Recovery
23:16 Hospital Guidelines and Doctor Preferences
23:56 Infection and Pain During Sex
24:30 Severe Perineal Trauma and Fourth Degree Tears
26:15 Shortening the Second Stage of Labor
29:45 Shoulder Dystocia and Episiotomy
31:10 Restrictive Episiotomy Policies
38:18 Factors Increasing Episiotomy Risk
40:02 Factors Lowering Episiotomy Risk
41:22 Importance of Discussing Episiotomy with Your Provider
44:46 Conclusion and Next Episode Preview
Resources:
- [Fetal expulsion: Which interventions for perineal prevention? CNGOF Perineal Prevention and Protection in Obstetrics Guidelines].
- Riethmuller D, Ramanah R, Mottet N.
- Gynecol Obstet Fertil Senol. 2018 Dec;46(12):937-947. doi: 10.1016/j.gofs.2018.10.029. Epub 2018 Oct 28.
- PMID: 30377094 French.
Mayo Clinic, Labor and delivery, postpartum care; Episiotomy: when it’s needed, when it’s not
Selective versus routine uses of episiotomy for vaginal birth
Hong Jiang 1, Xu Qian 1, Guillermo Carroli 2, Paul Garner 3
PMID: 28176333
PMCID: PMC5449575
DOI: 10.1002/14651858.CD000081.pub3
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