----- Original Message -----
Sent: Monday, August 22, 2005 11:51
PM
Subject: Re: [ozmidwifery] when to cut an
episiotomy
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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