Study Warns Against Unnecessary Episiotomies

Procedure should be done only when needed, researchers say

WEDNESDAY, Oct. 6, 2004 (HealthDayNews) -- Episiotomies -- incisions that widen the vagina during childbirth -- don't reduce the risk of injury to babies when their shoulders are stuck in the birth canal, says a Johns Hopkins University School of Medicine study.

The study authors wrote that, instead of an episiotomy, doctors should physically maneuver the infant to realign the shoulders to fit within the mother's pelvis. The pelvis is often the main cause of an infant getting stuck in the birth canal.

This approach will avoid unnecessary trauma to the mother and prevent injury to the baby. An episiotomy should be done only when doctors need more room to carry out the maneuvers to dislodge a baby stuck in the birth canal, the authors wrote.

"Most textbooks in obstetrics still recommend that physicians perform a generous episiotomy, yet there is no evidence that the procedure will reduce the likelihood of injury to the infant," lead author and high-risk obstetrician Dr. Edith Gurewitsch said in a prepared statement.

"An episiotomy is a surgical procedure that should only be performed when it is absolutely necessary," she said.

Gurewitsch and her colleagues analyzed 592 cases where there was difficulty delivering the baby's shoulders.

The study appears in the Oct. 5 online issue of the American Journal of Obstetrics and Gynecology.

More information

The U.S. National Library of Medicine has more about episiotomy.

SOURCE: American Journal of Obstetrics and Gynecology, news release, Oct. 5, 2004
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