Common Procedure During Delivery Linked to Lasting Rectal Injuries
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"It's been a difficulty in previous studies because many did not have a large enough sample size to separate out women who had an instrumental birth from those who didn't," Signorello tells WebMD. "But in our study the results are still strong and significant after you exclude anybody who had an instrumental birth or who had any labor complication. There was nothing else going on in these women except for the episiotomy."
In the U.S., episiotomy is performed in about 60% of live births, but that figure varies from doctor to doctor and hospital to hospital. Signorello says some hospitals still have episiotomy rates as high as 90% or more for first-time deliveries but says it is clear that many physicians are moving toward reserving an episiotomy for high-risk labor, such as when the baby is in distress and must be delivered in a hurry.
"Episiotomy is an example of medical technology that perhaps wasn't tested as well as it should have been before it was used in a widespread manner," Signorello says. "If you really look at the research, there's just no scientific basis for using this procedure as standard practice. Certainly, we don't give a C-section to every woman in labor, and this is the same sort of situation."
- Episiotomy is a surgical cutting of the perineal tissue between the vagina and the anus that is performed during labor to widen the birth canal, prevent severe tearing, and protect the anal sphincter muscle from damage.
- A new study shows that women who undergo episiotomy have more inability to control bowel movements and gas, compared with women who do not require episiotomy or whose perineum tore naturally during delivery.
- Researchers say the results call into the question the widespread use of episiotomy and suggest it be reserved for high-risk deliveries.