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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.
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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...
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