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.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Leaders of Tomorrow kicks off Jan. 16

Nominations accepted for youth recognition until Feb. 22

Team improves access to addiction, mental health supports

Service provides expanded on-call consultation

Hang up on the phone fraudsters

If the phone call seems kind of crazy…

Pinpointing innovations

How precision spraying system helps Kings Lake Hutterite Colony save time, products and water

County gravel pit requires wetland solution

County of Wetaskiwin hears report about wetlands at Hilgartner pit

VIDEO: Trudeau insists Iran respect families’ wishes when it comes to burials

All 176 people on board the Ukraine International Airlines flight PS752 were killed

Canadian public health agencies ramping up preparations in response to new virus

Health officials have said there are no confirmed cases of the emerging coronavirus in Canada

‘Naughty boy’: Monty Python star Terry Jones dies at 77

The comedian has been suffering from a rare form of dementia

Harry and Meghan should cover their own security costs: NDP heritage critic

The prince, Meghan Markle and their eight-month-old son Archie are reportedly staying at a mansion near Victoria

Alberta premier wants federal government to do more about opioid imports

Jason Kenney says Canada should find ways to cut down on drugs being smuggled into the country

Alberta Energy Regulator laying off staff, restructures, deals with budget cuts

Gordon Lambert, interim CEO, says the changes are part of a restructuring

Energy companies owe more than double the tax to Alberta municipalities

Survey says communities are owed $173 million — up 114% since last spring

No gondola from Banff to Mount Norquay, feds say

Parks Canada dismisses proposal for gondola, Grizzly Pavilion and boardwalks

Most Read