8. Episiotomies: History, Evidence and Current Practices

For the last 60-80 years an incision in the vaginal opening to help the baby come up has been used routinely, with some experts stating, there is no reason not to, so don’t even worry about it!  Yeah.. that was Dr Diethelm specifically, in 1938.  Speeding up the pushing stage, helping mom out after pushing for a long time, worrying about the baby being held inside by the tight perineum, trying to avoid major tears by giving a smaller incision, all in the hopes to help out.   Medical and surgical interventions became popular in the 1920s as deliveries moved to the hospital, of course! Most with the best intentions in mind.  They thought of a great idea, to use this procedure on everyone and with the help of forceps, totally eliminating the mom from having to push at all! Thanks!  But has the actual evidence held up this theory? Well get into it today!  Take what you’ve learned and start the conversation with your provider, remember knowledge is power! Stay informed and stay healthy! In this episode of the Birth Link Podcast, Colette discusses the topic of episiotomies in detail to help you navigate episiotomies for an empowered birth experience.00:00 Introduction and Personal Update00:13 Exciting New Ventures in Maternal and Newborn Care01:42 The Importance of Birth Plans and Privacy02:02 Hospital Experiences and Challenges04:30 Protecting Your Space During Labor05:37 Introduction to Episiotomies07:07 History and Evolution of Episiotomies14:20 Medical Perspectives and Practices21:29 Conflicting Evidence and Modern Views23:02 Episiotomy Risks and Recovery23:16 Hospital Guidelines and Doctor Preferences23:56 Infection and Pain During Sex24:30 Severe Perineal Trauma and Fourth Degree Tears26:15 Shortening the Second Stage of Labor29:45 Shoulder Dystocia and Episiotomy31:10 Restrictive Episiotomy Policies38:18 Factors Increasing Episiotomy Risk40:02 Factors Lowering Episiotomy Risk41:22 Importance of Discussing Episiotomy with Your Provider44:46 Conclusion and Next Episode PreviewResources:[Fetal expulsion: Which interventions for perineal prevention? CNGOF Perineal Prevention and Protection in Obstetrics Guidelines].Riethmuller D, Ramanah R, Mottet N.Gynecol Obstet Fertil Senol. 2018 Dec;46(12):937-947. doi: 10.1016/j.gofs.2018.10.029. Epub 2018 Oct 28.PMID: 30377094 French.            Mayo Clinic, Labor and delivery, postpartum care; Episiotomy: when it’s needed,          when it’s notSelective versus routine uses of episiotomy for vaginal birth                         Hong Jiang 1, Xu Qian 1, Guillermo Carroli 2, Paul Garner 3           PMID: 28176333           PMCID: PMC5449575           DOI: 10.1002/14651858.CD000081.pub3More from My Friend's a Nurse:Join us for the Next Childbirth Crash Course This September 18th-20th!Join us for the next Birth Plan Workshop!Join the newsletter for behind the scenes and episode insights you don't want to miss!Visit MyFriendsaNurse.comGrab this FREE Hospital Bag ChecklistEmail Colette directly for coaching availability and membership [email protected] you are interested in partnering or being a guest on The Birth Link Podcast please email [email protected] Connected:InstagramTikTokFaceBook