Study finds episiotomies reduce severe tearing risks in assisted births

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

A man wearing a face mask to prevent the spread of COVID-19 walks past a mural in Vancouver on Monday, Nov. 30, 2020. THE CANADIAN PRESS/Marissa Tiel
212 new COVID-19 cases in Interior Health over the weekend

A total of 490 cases remain active; 15 in hospital

This is the third year Raymond Imbeau and Barbara Kitz have picked up cans in the backcountry and donated the proceeds to COSAR. (Central Okanagan Search and Rescue)
Kelowna couple cleans forests for Central Okanagan Search and Rescue

Raymond Imbeau and Barbara Kitz donated $3,200 to COSAR

Lights will be on display for the annual Candy Cane Lane in Rutland until Jan. 1. - Mackenzie Britton/Capital News
Kelowna’s Candy Cane Lane to celebrate a decade of holiday lights

The event will run from Dec. 1 to Jan. 1, 2021

The video was used for (KGH Foundation - YouTube)
Okanagan filmmaker, poet win at L.A. Film Awards

Spoken word artist Shane Koyczan wrote and filmmaker David Nault produced the commercial

The Mission will be opening a temporary winter shelter starting on Dec. 1. (Kelowna’s Gospel Mission)
Gospel Mission’s winter shelter opens in downtown Kelowna

The temporary winter shelter will be in the former Kelowna Daily Courier offices

A B.C. Ambulance Service paramedic wearing a face mask to curb the spread of COVID-19 moves a stretcher outside an ambulance at Royal Columbia Hospital, in New Westminster, B.C., on Sunday, November 29, 2020. THE CANADIAN PRESS/Darryl Dyck
B.C. records deadliest weekend of COVID-19 pandemic with 46 deaths; more than 2,300 cases

Provincial health officer Dr. Bonnie Henry provides COVID-19 update

Fossil finds at Mt. Stephen. (Photo: Sarah Fuller/Parks Canada)
Extreme hiking, time travel and science converge in the Burgess Shale

Climb high in the alpine and trace your family tree back millions of years – to our ocean ancestors

Join Rob Dinwoodie and bandmates for a Cowboy Christmas, Dec. 11 and 12 at Vernon and District Performing Arts Center. Seating is cabaret style on the stage for an intimate concert. (Contributed)
North Okanagan cowboys go virtual for Christmas

Cowboy Christmas streamed Dec. 11-25

Vernon is getting in the Christmas spirit with many homes decorating with lights and extras. (Caitlin Clow - Morning Star)
Christmas lights tour mapped out by Vernon realtor

More than 20 of the community’s best lit houses make up annual tradition

Kettle bells sit aligned in an indoor fitness studio. (PIxabay.com)
1 COVID-19 case at a B.C. fitness studio leads to 104 more infections, 6 school exposures

According to case data released by Fraser Health, one case of the novel coronavirus carries a big impact

Vehicles drive past a display thanking essential workers in Burnaby, B.C. on Sunday, Nov. 29, 2020. THE CANADIAN PRESS/Marissa Tiel
B.C. changing COVID-19 case reporting as virus spread continues

Manual counting takes more time, leads to errors

Salmon Arm RCMP say some patrons have been harassing local businesses over mask requirements. (Lachlan Labere-Salmon Arm Observer)
Police urge respect after Salmon Arm businesses report being harassed over mask rules

Wearing of masks in businesses and public spaces is currently mandated by the province

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

Salmon Arm RCMP officers attended two public COVID-19 demonstrations held in Salmon Arm on Saturday, Nov. 28.  (File photo)
Organizer of Salmon Arm COVID-19 demonstration fined $2,000 by RCMP

Police said some participants weren’t aware of the public health order prohibiting gatherings

Most Read