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

Invermere gets new CAO

Invermere found his new CAO after a long period of research.

Radium council discusses short term rentals

RHS council are elaborating the second draft plan for STR

Beautification process begins in Canal Flats downtown

Canal Flats wants to improve the esthetic of the town

More consultation on LWRL to come this fall

Invermere council meeting discussed about the Athlamer neighbourhood plan

Local advocates for CBT climate change priority

Tracy Flynn ask the local government for action on climate change

Quirky Canadian comedy ‘Schitt’s Creek’ takes Emmys by storm with comedy sweep

Toronto-raised Daniel Levy and Ottawa-born Annie Murphy both got supporting actor nods

B.C.’s Chase Claypool catches first NFL touchdown pass

Abbotsford grad establishes new record for longest scrimmage TD by a Canadian

B.C. has highest number of active COVID-19 cases per capita, federal data shows

B.C. currently has 1,803 active cases after weeks of COVID-19 spikes in the province

Join Black Press Media and Do Some Good

Pay it Forward program supports local businesses in their community giving

Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

181 days gone: Family continues to look for man last seen in RCMP custody 6 months ago

Brandon Sakebow’s last known location was leaving Mission RCMP cell, police say; family has doubts

B.C. unveils new cannabis sales programs to help small, Indigenous growers

Government did not say how it will define small producers, but says nurseries will be included in the policy

Most Read