[ozmidwifery] 3rd degree tears

[Sue Cookson]

Hi, I've just returned from a clinical placement in SA where I spent a mindblowing three hours in an incontinence clinic in an outpatients unit at a major hospital. The mindblowing element was the following statistics (copied from one of the handouts): 39-49% women tear or have an episiotomy needing sutures 0.5 - 2.5% have a 3rd or 4th degree tear after vaginal childbirth that is visible 25-35% after first vaginal delivery have a concealed or closed 3rd degree tear, not visible Listed as contributing factors were: 1st vaginal birth forceps/instrumental delivery long second stage  >1 hour big baby    >4kgs tissue type, short perineum, epidural, uncontrolled pushing, rapid delivery, midline tear or episiotomy The nurse practitioner stated this was all evidence-based information and recommended c/sections to women who had had previous 3rd degree repairs - these were the ones who knew about their tears obviously. The handouts do not give references and as yet I have not had time to begin researching. Are you all as mindblown as I am?? What do you think - are 1/4 - 1/3 of us walking around with damaged anal sphincters and not aware of it?? Where does this sort of information lead us - if our bodies are so inept at giving birth then all first babies and subsequently all babies should be born by c/section. Sue