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26 August 2005
Time’s Up For Episiotomy, Say Experts 
In the past, doctors believed that episiotomy - a procedure that involves cutting a woman's birth canal at the time of delivery - was beneficial as it was thought to facilitate birth by preventing perineal trauma. This trauma was thought to be related to urinary incontinence later in life. It was also believed that a surgical incision would be less painful than experiencing a spontaneous perineal tear or laceration. But research over the last twenty years has shown that avoiding episiotomy can in fact mean less perineal trauma, less need for suturing, and fewer complications after birth. Despite these findings, and recommendations by prominent obstetric and nursing bodies, the rates of episiotomy being practiced during childbirth are still high. Dr. Ian Graham, at the University of Ottawa, has just completed a study into the rates of episiotomy around the world and found the highest rates to be in South and Central America and Asia. He noted that episiotomy rates vary by country as well by region and that among English-speaking countries, the rate is highest in the United States, although it is decreasing.
The study, published in the journal Birth, found that episiotomy rates overall were highest in Taiwan, with the procedure being used on 100 percent of patients. The lowest was Sweden, with a figure of 9.7 percent. In the United States, rates vary by region. In the Northeast, 38 percent of deliveries used episiotomy, but in the West only 27 percent utilized the practice.
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