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Nancy SullivanEpisiotomy--Tearing vs. Cutting
by Nancy Sullivan, CNM, MS, FACNM

Q. Most of the reading I have come across has stated that episiotomies are overused and most women don't need them. The instructor at my birthing class made the statement that "most, if not all, women need them" (she works at the practice I am at). I have also read that tearing heals better and does not have the long term effects that episiotomies have. What do you think? I am really interested in getting some feedback as I want to talk with my doctors about it and may have them write in my chart "No episiotomy".

A. Even the American College of Obstetricians and Gynecologists has come out with a statement that routine episiotomies are not indicated and should not be used. Most women do NOT need them. In our practice, about 5% of women have episiotomies. The main reason some doctors cut them routinely is that they don't know how to protect the perineum and avoid tears. In fact, tears are almost always less traumatic than the cut, and heal easier. For more information, check out the Episiotomy Page on my website, www.midwifeinfo.com.

I would be suspicious of any practice that disseminates the information that "most women need episiotomies." This is not true.

More on episiotomies:
  • Get Through Childbirth in One Piece! by Elizabeth Bruce, MA, CCE
  • Are Episiotomies Necessary? ~ a message board archive
  • Preventing an Episiotomy by Nancy Sullivan, CNM, MS, FACNM
  • Third Degree Tearing by Barbara Parker, RN, ARNP, CNM
  • Episiotomy Scar Problems by Barbara Parker, RN, ARNP, CNM

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