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

Crown declines to lay charges in Castlegar spree

RCMP were called to eight incidents regarding the same person in a six hour time frame.

Snowfall warning for Kootenay and Paulson passes

Up to 30 cm expected in mountain passes Saturday and Sunday.

Moose tests positive for Chronic Wasting Disease in northwest Montana

This is the first time the disease has been detected in the species in Montana

Community Futures launches cannabis consultation program

The Cannabis Business Transition Initiative helps businesses move into the legal economy

Police seize drugs, weapons and cash from Christina Lake residence

One man was arrested when RCMP executed a search warrant on Nov. 14

Cold, stormy winter forecast across much of Canada, The Weather Network predicts

In British Columbia temperatures will be slightly above normal and precipitation will be just below normal

UPDATED: Vancouver Island’s Joe gets suspended sentence in Teddy the dog cruelty case

Melissa Tooshley expected in court on Thursday in same case

Nineteen boats carrying invasive mussels stopped at B.C. borders

Waters of Columbia-Shuswap still test mussel-free

Woman ‘horrified’ after being told to trek 200 kilometres home from Kamloops hospital

‘I can’t get from Kamloops back to 100 Mile House injured, confused… no shoes, no clothes whatsoever’

Canadian universities encourage exchange students in Hong Kong to head home

UBC said 11 of its 32 students completing programs in Hong Kong have already left

Midget no more: Sweeping division name changes coming to minor hockey in Canada

Alpha-numeric division names will be used for the 2020-2021 season and beyond

Duncan man gets suspended sentence in Teddy the dog cruelty trial

Joe also gets lifetime ban on owning animals

B.C. pushes for greater ‘transparency’ in gasoline pricing

Legislation responds to fuel price gap of up to 13 cents

B.C. woman ordered to return dog to ex-boyfriend for $2,000

After the two broke up, documents state, they agree to share custody of the dog, named Harlen

Most Read