Episiotomies Are Becoming Less And Less Common, New Numbers Show

There was a time when episiotomy -- a surgical incision made in a woman's perineum -- was a routine part of childbirth in the United States, believed to help prevent the vaginal tears that can occur as babies emerge. But with the procedure leading to complications, including infection and even potential incontinence, doctors began stepping back from it in the 1990s. And promising new figures released this week suggest that rates have continued to fall after several major healthcare organizations in the mid 2000s spoke out against its routine use. In a short research letter published in the Journal of the American Medical Association, a team of researchers with Columbia University looked at claims of women who had vaginal deliveries at more than 500 United States hospitals between 2006 and 2012. During that time, episiotomy rates dropped from 17.3 percent in 2006 to 11.6 percent in 2012. Though the researchers are not sure what led to the decrease, they hypothesized that their findings "possibly" reflect recommendations of groups such as the American College of Obstetricians and Gynecologists, which in 2006 urged restricted use of the procedure. "The best available data do not support the liberal or routine use of episiotomy," the group wrote at the time, noting that in 2002, episiotomies were performed in roughly one-quarter of all vaginal births. There is a place for episiotomy, ACOG added, but it should be limited to difficult deliveries or to avo...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news

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CONCLUSIONS: There is insufficient evidence to make general conclusions about the effectiveness and safety of laxatives for preventing postpartum constipation. The evidence in this review was assessed as low to very low-certainty evidence, with downgrading decisions based on limitations in study design, indirectness and imprecision. We did not identify any trials assessing educational or behavioural interventions. We identified four trials that examined laxatives versus placebo, and one that examined laxatives versus laxatives plus stool bulking agents. Further, rigorous trials are needed to assess the effectiveness and sa...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
CONCLUSION: The most frequent pelvic floor dysfunctions (PFD) after birth were perineal pain, constipation, flatus incontinence, dyspareunia and IU respectively. It was seen that the symptomatic PFD was very common in the postpartum period. The results of the study emphasized the importance of lifestyle changes, avoiding perineal trauma during childbirth, and effective pelvic floor exercises in preventing PFD in pregnancy and postpartum. IMPACT STATEMENT: Nurses should acknowledge the importance of PFD after birth and identify the problems early period. Our study emphasizes size of the problem and improvement for PFD. ...
Source: Contemporary Nurse - Category: Nursing Tags: Contemp Nurse Source Type: research
ConclusionKnowing which factors are associated with the manifestation of SUI and dyspareunia in women after delivery is useful for identifying susceptible or "at risk" patients. These variables should be included in the clinical history of every pregnant woman.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionWarm compresses applied during the second stage of labor increase the incidence of intact perineum and lower the risk of episiotomy and severe perineal trauma.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionsVBAC does not confer an increased risk of OASI after a first delivery by caesarean section when compared with nulliparous women. The rate of successful VBAC may be contributory and suggests that the risk conferred by VBAC may be unit-specific. Unit and national-level audit is necessary to investigate this risk further.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
ConclusionsPrenatal EMG may be used to predict the impact of right-sided mediolateral episiotomy on EAS and perhaps also function following delivery.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
EFFECT OF DELIVERY AND EPISIOTOMY ON THE EMERGENCE OF URINARY INCONTINENCE IN WOMEN: REVIEW OF LITERATURE. Acta Clin Croat. 2016 12;55(4):615-24 Authors: Živković K, Živković N, Župić T, Hodžić D, Mandić V, Orešković S Abstract Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed medio-laterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from in...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
ConclusionSome combinations of delivery parameters and neonatal parameters seem to act together and may increase the risk of incidence of urinary incontinence six months postpartum in a synergetic way.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: Original Research Article Source Type: research
ConclusionSome combinations of delivery parameters and neonatal parameters seem to act together and may increase the risk of incidence of urinary incontinence 6 months postpartum in a synergetic way.This article is protected by copyright. All rights reserved.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: Original Research Article Source Type: research
Conclusion Endo-anal sonography might be a good screening tool for early detection of postpartum anal sphincter damages. However, further prospective cost benefit studies should be performed to propose it as a standard of care.
Source: Journal of Coloproctology - Category: Gastroenterology Source Type: research
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