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

RCMP, firefighters rally in support for health care workers in Kelowna

Pandosy Street was packed with supporters Saturday night

Apparent gas leak on Highway 33 in Kelowna

Emergency crews have taped off access to Centex Gas on Highway 33 near Asher Road

Kelowna RCMP plan mini parade past KGH to recognize health care workers

Kelowna officers will flash lights and sounds both Saturday and Sunday night

Perry and Stanley awarded top UBC Okanagan rookies

The volleyball star and soccer star won the prize over Heat’s virtual awards banquet

Interior Health officials outline pandemic response in virtual town hall

Kelowna-Lake County MLA Norm Letnick moderates digital discussion, Q&A with Interior Health leadership

B.C. is seeing the highest rate of COVID-19 recovery in Canada, and there’s a few reasons why

British Columbia was one of the first to see rise in COVID-19 cases, and has also switched up testing

UPDATE: Coronavirus concerns prompt event cancellations across the Okanagan

This is a running list of events cancelled across the Okanagan

No hesitation; two bystanders assist in South Okanagan house fire rescue

“I’d do it for anybody,” says Penticton man after assisting in house fire rescue

WATCH: Okanagan producer treats neighbours to live music from safe distance

Neighbours practiced social distancing as Jeff Johnson played songs from his front steps

Sewers stitch masks to free up supplies for front-line health-care workers

“We have little old ladies sewing up a storm,” said Joan Davis

Experts weigh in on best handling of groceries during COVID-19 pandemic

Study suggests the virus can live for up to 24 hours on cardboard and up to three days on plastic

COVID-19 world update: Enforceable quarantine in NYC?; France orders 1 billion masks

Spain warns EU’s future at stake; New York governor calls Trump’s idea ‘federal declaration of war

Earth Hour 2020 kicks off online Saturday night

Action moves online due to COVID-19

Okanagan woman baking for those in need amid COVID-19

Vernon’s Crystal Hedlund launched a GoFundMe page to generate funds for baking materials

Most Read