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

Mayor not in favour of low barrier housing at Oak Bay Lodge

Process is already in place to determine future of Oak Bay Lodge

Unemployment surpasses historic high in Greater Victoria, tourism hit hard

Hospitality and tourism sectors hurting as pandemic continues

Victoria seeks court order to enforce sheltering rules in Beacon Hill Park

People being asked to move out of environmentally sensitive areas of park

Victoria tattoo shops respond to sex assault allegations against male artists

Carne Tattoo and Painted Lotus Studios respond to allegations

MISSING: Victoria police search for high-risk missing woman last seen June 24

Amanda Williams is a 34-year-old Indigenous woman with short black hair and brown eyes

VIDEO: Langford cat missing 18 months reunited with family

Blue the cat found at Victoria museum 17 kilometres from home

Greater Victoria Crime Stoppers wanted list for the week of July 7

Greater Victoria Crime Stoppers is seeking the public’s help in locating the… Continue reading

POLL: Would you get a vaccine for COVID-19 when it is available?

With the number of positive COVID-19 tests skyrocketing across much of the… Continue reading

VIDEO: Alberta man rescues baby eagle believed to be drowning in East Kootenay lake

Brett Bacon was boating on a lake in Windermere when he spotted the baby eagle struggling in the water

Vancouver Island business ad unintentionally features OK gesture linked to white supremacy

Innocuous ‘OK’ gesture in cleaning franchise advertisement gets flak on social media for ‘supposedly’ promoting white supremacy

Comox Valley RCMP looking for missing woman

Ami Guthrie was last seen in Courtenay in early July

Conservationists raise concerns over state of care for grizzly cubs transferred to B.C. zoo

‘Let them be assessed now before their fate is sealed,’ urges B.C. conservationist Barb Murray

B.C.’s COVID-19 job recovery led by tourism, finance minister says

Okanagan a bright spot for in-province visitor economy

National Kitten Day aka the ‘purrfect’ day to foster a new friend

July 10 marks National Kitten Day, a special day to celebrate all things kittens

Most Read