The work by Onah (7) and Azria and colleagues (12) had similar findings of episiotomies
being significantly more in HIV negative women compared with HIV positive women.
We questioned why obstetricians and midwives still perform routine episiotomies
in Cambodia while the evidence shows that it is not beneficial for women.
A study20 surveyed women for dyspareunia, and reported that pain at first postpartum intercourse was less among those with spontaneous tears than among those with episiotomies
, while fractions having resumed sexual relations at six weeks and level of sexual satisfaction were similar.
This finding is not surprising probably because many of the midwives still practise the policy of preventing uncontrolled perineal tears by performing episiotomies
on nulliparous subjects in many parts of this country.
A comparison between midline and mediolateral episiotomies
While some episiotomies
may still be medically necessary, says Dr.
are also carried out more frequently than average - but other forms of intervention are at average levels.
Most midwives, though trained to do episiotomies
, don't do them routinely.
Traditionally, physicians have used episiotomies
to minimize perineal trauma and postpartum pelvic floor dysfunction.
Norwitz reviewed failed to consider blood loss, postpartum healing, and subsequent dyspareunia when comparing midline and mediolateral episiotomies
Shiono P,Klebanoff MA, Carey JC Midline episiotomies
:more harm than good?
A number of practices were found that did not follow current guidelines: routine enemas and episiotomies
, forbidding companionship during labour, use of procedures to speed labour without indications, restriction of mobility and oral fluids, supine position for delivery and absence of active management of the third stage of labour.