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Episiotomy: can its routine use be defended?

J M Thorp¹, W A Bowes

¹Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill.

American Journal of Obstetrics and Gynecology

|May 1, 1989

Summary

Routine episiotomy, a common procedure in the United States, lacks strong evidence for its purported benefits in reducing perineal trauma or preventing pelvic relaxation. Further research is needed to determine the actual benefits of episiotomy.

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Area of Science:

Obstetrics and Gynecology
Women's Health Research

Background:

Episiotomy is a standard procedure during childbirth in the United States.
The procedure is traditionally justified by claims of reduced perineal trauma and prevention of pelvic relaxation.

Purpose of the Study:

To critically evaluate the evidence supporting the routine use of episiotomy.
To investigate the actual effects of episiotomy on maternal outcomes.

Main Methods:

A comprehensive review of existing medical literature and studies on episiotomy.
Analysis of data regarding perineal trauma and pelvic floor function post-delivery.

Main Results:

Limited scientific evidence supports the routine use of episiotomy.

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Findings suggest episiotomy may increase the risk of severe perineal lacerations (third- and fourth-degree).

Conclusions:

The traditional rationale for routine episiotomy is not well-supported by current evidence.
Further research is essential to ascertain the true benefits and risks of episiotomy in obstetric care.