|
-----SORRY i sent this to denise and not the
list trish
my original message was about a tear not an
episiotomy and whetter it was really necessary to suture. though on that note I
have recently began to follow maggie Bank's lead and now refer /or correct the
word episiotomy as " cutting open the vagina" I believe the word
episiotomy effectively minimises the true impact of the procedure.
trish
Let's all go back to the Cocherane Database and
Midris there is copious data on the inappropriate use of episiotomy
I quote Effective care in
Pregnancy....
"Like any surgical proceedure episiotomy
carries risks.........
"The most common cause of perineal damage
is epsiotomy........"
Or Henci Goer;
"In a branch of medicine rife with
paradoxes, contradictions, inconsistencies and illogic episiotomies crown
them all........"
I thought midwives were/are being instructed in
midwifery by midwives not obstetrics ?
Denise
----- Original Message -----
Sent: Tuesday, October 16, 2001
9:03 AM
Subject: Re: suturing
I learnt from one of our students yesterday
that our current registrar, *sigh*, is telling the students to cut an
episiotomy when the head is distending the peri 'too slowly'. His
argument was that a head sitting on the peri too long is going to cause
MORE swelling than necessary.
She was confused because she knows the midwives
current modes of practise is to allow the head as much time on the peri
a) as long as the mother can tolerate it, b) if babies' heartrate doesnt
cause panic to those whom such heartrates might cause panic c) to
give the peri time to accomodate stretching.
She was also confused because she knows that
most midwives in our units are likely to need to do about 1 episiotomy a
year....
And on that note, do many people use hot packs
on peri's during 2nd stage? I thought there was a trial happening
somewhere and I wonder what the outcomes were.
Robin
----- Original Message -----
Sent: Tuesday, October 16, 2001
10:23 AM
Subject: Re: suturing
. the
repairer even commented that the main benefit was that it
wouldn't burn when she pees.
She could lean forwards while she wees,
couldn’t she? From a consumer’s viewpoint all that
I’ve heard/read about episiotomies show that cutting with
scissors will make a deeper cut (slicing and crushing into the
deeper layers of skin and underlying muscle) which does not heal as
well as a natural tear would. I know some tears are big, and ragged,
and may need to be sutured, but I’ve heard tears generally
heal better than an episiotomy.
How about some episiotomy
prevention? Warm packs, gentle hands, gentle pushes, water, slow
second stage – again, I know that there are emergency
situations that evolve during birth, I just don’t think the
current episiotomy rate is a true indication of how useless
perineums are at stretching.
The list once discussed putting
the episiotomy scissors in a separate sterile pack, which was then
placed in a drawer, etc, so that they weren’t
‘handy’ during that crucial moment of decision. I think
this is a great way to start decreasing the episiotomy rate. Whoever
thought of this initiative truly understands human motivation
– if it’s there, use it...
I once
read:
“If God can make a tree (substitute anything you like
here – blade of grass, etc) with perfection, why do we think
He/She can’t make perineums that work
perfectly?”
Birthing Beautifully,
Jackie
Mawson.
Convenor of Birthrites: Healing After Caesarean
Inc.
Visit our Website at: http://www.birthrites.org
Email:
[EMAIL PROTECTED]
Phone: 61 08 9418 8949
Please note I
am not a Professional Healthcare Provider, and all opinions given in
this email are not to be taken as medical, or legal, advice. Please
seek such advice from the relevant professional
service.
Email me your postal details for a FREE copy of our
quarterly magazine, if you live within Australia - Overseas postage
costs are above budget, sorry!
Too many
Gods;
so
many
creeds,
Too
many
paths
that
wind
and
wind,
When
just the
art
of
being
kind
Is
all the
sad
world
needs...
----------------------------------
|
