to Avoid Episiotomy
Angela Monti Fox, LCSW
The following is a brief summary of several studies showing how
Episiotomy considered "routine" and practiced widely in the
United States, has little scientific reason for its continued use.
In fact research on the Kegal exercise and the Perineal Massage show a
significant reduction in "Episiotomy and Perineal tearing" when
these two approaches are practiced.
HypnoBirthing is as much a philosophy as it is a method of childbirth.
As such, our childbirth education course in HypnoBirthing includes careful
attention to alternative methods that can help prevent unnecessary medical
intervention. Thus we not only teach women to practice perineal massage
and the Kegal exercise in order to reduce and in most cases avoid unnecessary
episiotomy and tearing, we also use post hypnotic suggestion to encourage,
motivate and support the practice of Perineal massage and the Kegal exercise.
What is Episiotomy and is it really necessary? An episiotomy is a surgical
incision in the perineum, the area of skin between the vagina and the
anus. It use has been routinely defended by the medical profession as
necessary to prevent tearing, protect against incontinence later on in
life and aid pelvic floor relaxation during delivery. In addition, it
is claimed to speed up birth, prevent damage to the baby, and heal easier
than spontaneous tears that may occur during delivery. In spite of the
prolonged insistence of the medical profession as to these outcomes medical
research has not proven any of these benefits. In many cases research
has shown the opposite effect: infection, increased pain, increase incidence
of 3rd and 4th degree vaginal lacerations, longer healing and discomfort
and increased discomfort upon the resumption of sexual intercourse. Henci
Goer, in her book Obstetric Myths versus Research Realities, states: "routine
or prophylactic episiotomy to prevent perineal tears (as opposed to episiotomy
for specific indication such as fetal distress) is the quintessential
example of an obstetrical procedure that persists despite a total lack
of evidence for it and a considerable body of evidence against it".
In fact, Goer states that every study has found that deep tears are almost
exclusively extensions of Episiotomies." (Goer, Henci, Obstetric
Myths Versus Research Realities)
A recent article published in the Wall Street Journal (March 30, 2000)
offers an excellent account of the history of episiotomy as well as a
survey of recent research decrying the procedure as excessive. Performed
on millions of American women for its supposed benefits in spite of an
outstanding series of studies which point to the lack of scientific evidence
to justify its continue use. A 1982 review of 350 books and articles on
episiotomy by Stephen Thacker of the U.S. Center for Disease Control and
Prevention concludes that arguments in favor of routine cutting to prevent
lacerations, protecting pelvic muscle tone and preserving sexual function,
do not withstand scientific scrutiny.
Research and nurse-midwife at UCSF, Judith Bisthop states, "The indications
for episiotomy-sparing the fetal head and the maternal bottom-didnt
hold water, ...what helps, states midwife Elsa Heros, is not rushing the
birth, just letting the babys head do the stretching and patiently
waiting there with Mom." (Wall Street Journal, 3/30, 2000)
In conclusion, the studies reported summarize the health hazards associated
with episiotomy and its overuse. The following are some preventative measures:
Good nutrition (healthy skin stretches more easily)
Kegels (exercise for your pelvic floor muscles
Prenatal discussion with your care provider about episiotomy
Prenatal Perineal Massage
A slowed second state (controlled pushing)
Warm compresses, perineal massage and support during delivery.
Our HypnoBirthing childbirth education class will help you with the practice
of each of the preventative measures.
Research on Effects of Hypnobirthing
on Labor & Delivery
Overcome the Fear & Pain of
Childbirth Using Hypnosis
What you should know about Cesarean
is taught in Group & Individual sessions.
These Sessions may also be
Birthing With Hypnosis
Avenue at 20 Street, Suite 534 # 7
New York, NY 10010
Please call 1 800 414 6274 or (646) 519 1076