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In my training, in UK in '79, the episiotomy rate
was very high. Of my 30 obligatory deliveries, 29 had epis, the 30th being a
multip who delivered too quickly for anyone to push scissors into my
hands. I was only taught how to deliver with one, no effort was made to
teach how to protect the perineum. Mind you, we were excellent at
infiltration and cutting!
The obs at the time's view was " all primips need
one and all multips who have previously had one!"
Over the years my incidence of performing them
reduced, and of the past 250 births I have performed epis on 7 occasions, almost
without exception for fetal compromise.
Sadly, we once again seem to be coming up against
the (medical) viewpoint that we are not doing enough! None of my
colleaugues perform routine epis, and our rate is low, and lately we have had
several 'remarks' from doctors who have been asked to suture tears, that we
should have done an epis.
I have even heard the physio telling women that
they are a good idea!
Interestingly, I have seen far fewer 3' tears since
seeing a huge reduction in epis rates, used to see them on a regular
basis.
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"
Edmund Burke
----- Original Message -----
Sent: Monday, August 22, 2005 6:06
AM
Subject: Re: [ozmidwifery] when to cut an
episiotomy
I think many midwives can claim very good episiotomy rates.
Mine over twenty years in "0". My virginal scissors get taken to each birth
but have never been out of the packet except to be put in a new packet and re
sterilised. Who else would like to celebrate their lack of desire or interest
in cutting a woman's perineum.
Andrea Quanchi
On 21/08/2005, at
6:57 PM, Janet Fraser wrote:
I'm not one of the
professionals in here, Paivi but hi anyway. : ) I've read in a few
places about how episiotomy rates suddenly drop when studies into them
begin. A hb MW I know does less than one a year so I figure that's a good
guide. Mostly in hospitals they're performed for no reason at all
but the damage they do to women's bodies and psyches horrifies me. It's
sanctioned genital mutilation. In birth planning meetings I run I suggest to
women that they never put their bodies in a position that can be easily
reached by someone with scissors. Our rates are very high in Australia. Well
IMO, any rate of episiotomy is too high unless it's negligible.
Just
my 2c ;
)
Janet
----- Original
Message -----
From:
Päivi
To:
[email protected]
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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