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----- Original Message -----
Sent: Monday, August 22, 2005 8:52 AM
Subject: Re: [ozmidwifery] when to cut an episiotomy
Paivi<
This article was in a Melbourne newspaper 12 months
ago, probably quite current stats. It can be seen in it's entirety
on:
I have been working in Mid since 1979 & cut the
required 5 episiotomies in my training, since then have cut 2 in the last
20 years, both for fetal distress.
BM
To cut or not: debate on childbirth procedure
By Amanda Dunn
Health
Reporter
August 13, 2004
A surgical cut to make room for the baby's head in a
vaginal birth is too commonly performed in private Victorian hospitals, an
obstetric expert has warned.
Obstetric epidemiologist James King also told The Age that,
conversely, severe vaginal tears during childbirth are more prevalent in public
hospitals, which may indicate the need for better supervision of inexperienced
doctors.
"Sometimes it (cutting) is absolutely necessary, but it's probably overused,"
he said.
His comments followed a report commissioned by the Department of Human
Services, which found that between 1999 and 2002, an episiotomy - in which an
incision is made through the perineum at the entrance to the vagina - was given
to one in every three private patients, compared with one in five public
patients.
Professor King, who led the review, said the
difference between public and private rates may be because vaginal deliveries
were more likely to be supervised by midwives in the public system, who
supported lower episiotomy rates.
Euan Wallace, an obstetrician at Monash Medical
Centre, said it was once the orthodox view that episiotomy was preferable to
allowing a vaginal tear because it preserved pelvic floor muscles. But evidence
since has challenged that view.
----- Original Message -----
Sent: Sunday, August 21, 2005 6:31
PM
Subject: [ozmidwifery] when to cut an
episiotomy
A mom asked me when is episiotomy really needed.
She had asked from many professionals, and all just gave her the answer, that
"They will try to avoid episiotomy, but will cut just in case, if not sure".
In Finland the episiotomy rates are from 4% to 50%, and for
firsttime moms from 9% to 88%!. It is usually beleived, that the midwife will
know best. (That is a medicalaized hospital midwife in most cases). I
already know, that you have a different opinion on when it is needed,
but it would be interesting to know from you, who work as midwifes, how
often have you performed episiotomies? Does anyone know, what is the
national average in the Australian hospitals?
Paivi
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