alice
as a grad of unisa (1st year) going into the hospital system i was rather
horrified that we were expected to cut episiotomies i can however say that i
have not cut one thus far although i am only in my first year out.
good luck with your theisis.
regards  sharon
----- Original Message -----
From: "Alice Morgan" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Thursday, November 03, 2005 12:49 AM
Subject: RE: [ozmidwifery] article FYI


>
> This is interesting for me. I am currently writing my midwifery honours
> thesis on women's views about episiotomy (or trying to at least,
> unfortunately I am having great difficulty with participant recruitment).
> It's always nice to see more research backing up what I am saying.
>
> :) Alice (one of the first SA BMid grduate midwives)
>
>
> >From: "leanne wynne" <[EMAIL PROTECTED]>
> >Reply-To: [email protected]
> >To: [email protected]
> >Subject: [ozmidwifery] article FYI
> >Date: Wed, 02 Nov 2005 11:05:02 +1100
> >
> >Unnecessary episiotomies
> >Issue 22: 31 Oct 2005
> >Source: International Journal of Gynecology & Obstetrics 2005; 91: 157-9
> >
> >Researchers have questioned the continuing widespread use of routine
> >episiotomy, after finding high rates at some centres in countries in
South
> >America, Asia, and Africa.
> >
> >Systematic reviews of published trials, including a Cochrane review, have
> >suggested that episiotomies should not be performed routinely, because of
> >the associated maternal morbidity.
> >
> >Some specialists have said that no more than 10 percent of nulliparous
> >women delivering vaginally should need one, according to the researchers
> >writing in the latest issue of the International Journal of Gynecology &
> >Obstetrics.
> >
> >But their study suggests that episiotomy rates are far higher than this
at
> >some hospitals. The researchers, from Uruguay and the USA, analyzed data
on
> >episiotomy rates for nulliparous and multiparous women at hospitals in
> >Argentina, Brazil, Bolivia, Chile, the Democratic Republic of Congo,
> >Ecuador, India, Tibet, Uruguay, Venezuela, and Zambia.
> >
> >The hospitals studied (from 1 to 13 per country) were part of the US
> >National Institute of Child Health and Human Development's Global Network
> >for Women's and Children's Health Research.
> >
> >Rates above 90 percent
> >Reporting their findings, the researchers say that episiotomy rates among
> >nulliparous women were higher than 90 percent in all countries except
> >Zambia (6.9 percent).
> >
> >Episiotomy rates for all vaginal births were higher than 20 percent in
all
> >countries except Zambia, and were as high as 80 percent in Brazil.  The
> >exception, Zambia, was unusual in having a lower rate for nulliparous
women
> >than for all vaginal births. The researchers, however, caution that the
> >data for Zambia were obtained from only one hospital.
> >
> >They also advise against generalizing the findings beyond the centres
> >studied. However, they say the data "illustrate the widespread use of
> >routine episiotomy. in contradiction to the evidence questioning its
> >efficacy."
> >
> >Unnecessary episiotomies, the researchers write, increase the risk of
> >morbidity as indicated by the Cochrane review, including posterior
perineal
> >trauma, the need for suturing the perineal wound, and healing
complications
> >at 7 days.
> >
> >They conclude: "Strategies should be developed to decrease episiotomy
rates
> >at a global level."
> >
> >
> >
> >Leanne Wynne
> >Midwife in charge of "Women's Business"
> >Mildura Aboriginal Health Service  Mob 0418 371862
> >
> >
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