Episiotomy is Out - Finally!

Last week the American College of Obstetricians and Gynecologists released a Practice Bulletin that effectively condemns the routine practice of episiotomy. I found the recommendations unusually blunt for ACOG; normally these guidelines are more politically correct.

Now there's good evidence to confirm what most midwives and conscientious doctors have understood for years: that in most cases, women will give birth with less trauma to the perineum without episiotomy than they sustain when one is cut.

I do believe that very experienced practitioners sometimes make the wise call that an appropriately chosen episiotomy might be preferable to severe lacerations, but those instances are rare, and the call is mostly subjective rather than objective. These instances should be exceptions rather than the rule, and ACOG wisely states that practitioner's track record could be used as an indicator of quality.

And, it goes without saying, that a patient who wishes to avoid episiotomy should have her request respected, no matter what the potential outcome seems to be.

RW, MD

Related Topics: Episiotomy May Not Help Most Mothers, Labor and Delivery