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

Council briefs: The Village of Queen Charlotte

More money for village in third-quarter, new equitable gift giving policy

William Griffin arrested in Houston homicide

RCMP have now arrested William Griffin, the man wanted in connection to… Continue reading

Family of Terrace man killed in hit-and-run plead for tips, one year later

Cameron Kerr’s family says the driver and passengers tried to cover their tracks

Coast Mountain College’s indigenization efforts recognized at international symposium

Collaboration and community are key to Indigenous reconciliation in education, CMTN says

Abortions rights advocates urge Liberals to turn politics into policy

Conservative Leader Andrew Scheer was pressed to clarify his stance abortion over several weeks

Cleanup in the works after tanker truck fire leads to oil spill in B.C.’s Peace region

The province said the majority of the spilled oil likely burned away in the fire.

BC VIEWS: Action needed on healthcare workplace violence

While we’ve been talking about it, the number of B.C. victims has only grown

Closing arguments begin in B.C. case launched in 2009 over private health care

Dr. Day said he illegally opened the Cambie Surgery Centre in 1996 in order to create more operating-room time

MacLean says “Coach’s Corner is no more” following Cherry’s dismissal from Hockey Night

Cherry had singled out new immigrants in for not honouring Canada’s veterans and fallen soldiers

MacKinnon powers Avs to 5-4 OT win over Canucks

Vancouver battled back late to pick up single point

Poole’s Land finale: Tofino’s legendary ‘hippie commune’ being dismantled

Series of land-use fines inspire owner Michael Poole to sell the roughly 20-acre property.

Port Alberni mom takes school district to court over Indigenous smudging, prayer in class

Candice Servatius, who is an evangelical Christian, is suing School District 70

Family of B.C. man killed in hit-and-run plead for tips, one year later

Cameron Kerr’s family says the driver and passengers tried to cover their tracks

Most Read