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

Tigh-Na-Mara general manager Paul Drummond, left, and SOS executive director Susanna Newton right are prepared for a reinvented Tigh-Na-Mara Toy Drive in 2020. COVID-19 will not spoil the community’s annual day of giving and help for local families through the SOS Caring for Community at Christmas program. (Peter McCully photo)
Reinventing Parksville Qualicum Beach’s popular Tigh-Na-Mara Toy Drive

COVID-19 restrictions won’t spoil community’s annual morning of giving

Map of the location of the Telus cell tower that it plans to build in Qualicum Beach. (Town of Qualicum Beach Map)
Qualicum Beach council approves location of Telus communications tower

Plan is to improve cellphone service in the area

The City of Quesnel has painted its functional fire hydrants with different characters. (Quesnel Downtown Association Photo)
Qualicum Beach committee wants fire hydrants painted with sea life designs

Local artists would be invited to help with the work

B.C. provincial health officer Dr. Bonnie Henry gives a daily briefing on COVID-19 cases at an almost empty B.C. Legislature press theatre in Victoria, B.C., on March 25, 2020. (Don Craig/B.C. government)
B.C. sees 223 new COVID-19 cases, now 2,009 active

Two new care home outbreaks in Surrey, Burnaby

100 Mile Conservation officer Joel Kline gingerly holds an injured but very much alive bald eagle after extracting him from a motorist’s minivan. (Photo submitted)
B.C. driver thought he retrieved a dead bald eagle – until it came to life in his backseat

The driver believed the bird to be dead and not unconscious as it turned out to be

Police in Nanaimo are looking for a woman who allegedly threw hot coffee on a McDonald’s employee. (News Bulletin photo)
UPDATE: Nanaimo RCMP still looking for woman who threw coffee at worker after already receiving refund

Police asking for information in investigation that could lead to assault charges

Chastity Davis-Alphonse took the time to vote on Oct. 21. B.C’s general Election Day is Saturday, Oct. 24. (Chastity Davis-Alphonse Facebook photo)
B.C. reconciliation advocate encourages Indigenous women to vote in provincial election

Through the power of voice and education Chastity Davis-Alphonse is hopeful for change

White Rock RCMP Staff Sgt. Kale Pauls has released a report on mental health and policing in the city. (File photos)
White Rock’s top cop wants to bill local health authority for lengthy mental-health calls

‘Suggestion’ included in nine-page review calling for ‘robust’ support for healthcare-led response

A Le Chateau retail store is shown in Montreal on Wednesday July 13, 2016. Le Chateau Inc. says it is seeking court protection from creditors under the Companies’ Creditors Arrangement Act to allow it to liquidate its assets and wind down its operations.THE CANADIAN PRESS/Ryan Remiorz
Clothing retailer Le Chateau plans to close its doors, files for CCAA protection

Le Chateau said it intends to remain fully operational as it liquidates its 123 stores

Green party Leader Sonia Furstenau arrives to announce her party’s election platform in New Westminster, B.C., on October 14, 2020. THE CANADIAN PRESS/Jonathan Hayward
B.C. Green party says it’s raised nearly $835,000 in 38 days

NDP Leader John Horgan is holding his final virtual campaign event

U.S. border officers at the Peace Arch crossing arrested two men on California warrants this week. (File photo)
Ottawa predicts system delays, backlogs unless court extends life of refugee pact

Canada and the United States recognize each other as safe places to seek protection

Most Read