Study finds episiotomies reduce severe tearing risks in assisted births

The study examined more than 2.5 million births in Canada

Episiotomies during childbirth have declined in Canada, but a new report says the surgical cuts could reduce the chance of a mother being severely injured when forceps or a vacuum are involved.

A large study published Monday in the Canadian Medical Association Journal found episiotomies reduced the risk of injury by as much as 42 per cent when first-time mothers required assistance from a vacuum or forceps, which are broad pincers used to grab a baby’s head.

In contrast, a surgical cut posed greater risk of injury when forceps or a vacuum were not involved.

Study author Giulia Muraca, a postdoctoral fellow at the University of British Columbia, says guidelines that discourage routine episiotomies have been overgeneralized to apply to all vaginal deliveries, when data suggests they could help in assisted births.

“Generalizing the episiotomy guidelines for spontaneous vaginal delivery to women with operative vaginal delivery can cause harm, particularly in women delivering their first child and in women having a vaginal birth after caesarean,” Muraca said Monday in a release.

An episiotomy is a surgical cut made to the opening of the vagina when the baby’s head appears.

It’s meant to create more room and minimize severe tears, which could include obstetric anal sphincter injury and cause pain, infection, sexual problems and incontinence.

Researchers say the risk of severe tearing was highest among deliveries by forceps and vacuum, with about 18 per cent of assisted deliveries resulting in such injuries in 2017.

The study examined more than 2.5 million births in Canada between 2004 and 2017 and found the procedure declined among vaginal deliveries, whether they involved instruments or not.

They involved 43.2 per cent of assisted births in 2017, down from 53.1 per cent in 2004. For unassisted births, rates dropped to 6.5 per cent in 2017, from 13.5 per cent in 2004.

Nevertheless, injuries increased 15 per cent in Canada and other industrialized countries — but researchers say that’s possibly due to improved detection and reporting, and the increasing number of older first-time mothers.

Randomized controlled trials in the 1990s showed episiotomies to be ineffective in protecting women from severe tearing, instead increasing pain and extending recovery time.

From 2015 to 2017, assisted deliveries accounted for 10 per cent to 13 per cent of deliveries in Canada, the United Kingdom and Australia.

The rate of assisted delivery is notably lower in the United States, at 3.1 per cent in 2015, where efforts to increase assisted deliveries and reduce caesarean delivery rates are underway.

Cassandra Szklarski, The Canadian Press


Like us on Facebook and follow us on Twitter.

Just Posted

Wolf Creek Public Schools appoints new facilities manager

Kevin Henderson to take over after Len Landry’s retirement

Ponoka UFA celebrates grand opening

New farm and ranch supply store is larger, has new features

Four Maskwacis residents charged with 38 crimes Nov. 9

Maskwacis RCMP: four arrested following armed robbery, pursuit and home invasion

Ponoka Broncs fall to Wetaskiwin in final home match

Five graduating players honoured, recognized for their contributions

At least 3 hurt in California school shooting, gunman sought

Los Angeles County Sheriff’s Department looking for a male suspect in black clothing was seen at the location

Premier vows to fight for oilpatch as drillers forecast almost no growth in 2020

The CAODC said it expects the Canadian drilling rig fleet to continue to shrink

NDP Leader Jagmeet Singh to meet with Trudeau today to discuss throne speech

Top ask will be for Liberal support for the immediate creation of a national universal pharmacare program

Jagmeet Singh says he’ll vote against throne speech if NDP requests not met

Singh is to meet with Prime Minister Justin Trudeau on Thursday

PHOTOS: Ponoka Legion’s Remembrance Day ceremony

Guest speaker Ron Labrie recounts moving story of fallen Ponoka airman

Small group of Cherry fans protest his firing at Rogers HQ

One sign at the Toronto rally: ‘Rogers cancels Don, we cancel Rogers’

Ideas for Alberta independence would increase costs, Nenshi says

Province has formed panel to examine how to get what a ‘fairer deal’ from Confederation

UPDATED: Alexandra Lewis has been located

UPDATED: Alexandra Lewis has been located, safe and well. ORIGINAL STORY: Ponoka… Continue reading

Most Read