Episiotomy Rates Found Higher than Recommended

A study has found high rates of episiotomy use among private practitioners, despite current evidence-based literature and professional guidelines that support restricted use. The results were reported in the January 2004 issue of Obstetrics & Gynecology.

An episiotomy is a tiny cut designed to enlarge the birth canal opening, and in some cases may be needed to aid delivery. However, the practice became quite widespread, being used in more than half of all vaginal deliveries in the 1980s because of the belief that it could prevent tears and preserve muscle tone. It also hastened delivery. In 1992, however, new guidelines were issued by the American College of Obstetricians and Gynecologists (ACOG) after studies revealed that complications and pain were more common after episiotomy. The new guidelines stated that episiotomy is not required and in fact may result in serious lacerations.

In the current study, researchers studied more than 27,000 women with 15,190 episiotomies, for an average rate of 54.8%. Women being cared for by private practitioners were found to have a seven-fold increased risk of episiotomy, compared to academic practitioners. The researchers were from the University of Pittsburgh Health Sciences Center, Magee-Womens Hospital (PA, USA).




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