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

Quesnel gold pan relocation prompts rally, response from mayor

“At its current location, it doesn’t let us tell our story”

Status of C&C Wood Products focus of discussion at Quesnel city council meeting

Mayor Bob Simpson said he hopes a formal statement can be issued soon surrounding its future

Cariboo ranchers, lodge operators say Indigenous land title shuts them out

Tsilhqot’in jurisdiction affects grazing, access to private property

Flood watches issued for Quesnel, Horsefly Rivers

Flows rising in response to snowmelt and rainfall, continued rises expected

RCMP urge Williams Lake residents to be cautious as suspect remains on the loose

Man seen speeding on Highway 97 fled from police after colliding with RCMP vehicle

If Trudeau won’t stand up to Trump, how will regular people: Singh

Trudeau did not directly answer a question about Trump’s actions amid protests

VIDEO: Internal investigation into aggressive arrest by Kelowna Mountie

A video allegedly shows a Kelowna Mountie striking a man several times

22 new COVID-19 test-positives, one death following days of low case counts in B.C.

Health officials urged British Columbians to ‘stand together while staying apart’

John Horgan says COVID-19 restrictions won’t be eased regionally

B.C. Liberals urge ‘tailored’ response based on infections

Feds get failing grade for lack of action plan on anniversary of MMIWG report

‘Instead of a National Action Plan, we have been left with a Lack-of-Action Plan’

As two B.C. offices see outbreaks, Dr. Henry warns tests don’t replace other measures

Physical distancing, PPE and sanitizing remain key to reduce COVID-19 spread

Greater Victoria drive-thru window smashed after man receives burger without mustard

Greater Victoria Wendy’s staff call police after man allegedly rips Plexiglas barrier off window

Murder charge upgraded in George Floyd case, 3 other cops charged

Floyd’s family and protesters have repeatedly called for criminal charges against all four officers

Young killer whale untangles itself from trap line off Nanaimo shore

DFO marine mammal rescue unit was en route as whale broke free from prawn trap line

Most Read