Researchers: Doctors Should Stop Routine Episiotomies

If anyone you know is having a baby sometime soon, be aware that researchers Dr. Erica Eason and Dr. Perle Feldman report in the April, 2000 issue of the journal Obstetrics and Gynecology that there is no evidence to support the use of routine episiotomies during medical deliveries and that doctors should discontinue the practice.

Episiotomies involve cutting the muscles between the vagina and anus during the delivery process, supposedly to make the birth process easier for both mother and baby. This study, however, found that there are no advantages to continue using it. According to the researchers, "it is clear that episiotomy is a major contributor to trauma, pain, and suffering."

Doctors have always thought that babies born without having episiotomies were at a higher risk for brain damage but the authors report that no studies have found any neurological function differences between babies whose mothers had the procedure and those who have not.

Doctors also thought that episiotomies helped prevent damage to the mother's pelvic muscles. Not only did the authors find there were no studies to support this notion, but women who had episiotomies had more problems after birth with incontinence from weak pelvic muscles.

So, why do doctors continue to do procedures that have no research evidence to support the use? Drs. Eason and Feldman say it's because they feel (against all of the evidence) that cutting the muscles is helpful and they believe they should be doing something during the birth.

While the procedure does speed up the process somewhat, the authors say "We certainly would not wish to threaten the well being of our patients for our own momentary convenience. If a routine intervention is neither good for infants nor good for women, the fact that it is sometimes good for [obstetricians] should be acknowledged and put in its proper perspective."