BMJ 1998;316:1179-1180 ( 18 April )

Editorials

Routine episiotomy in developing countries

Time to change a harmful practice 

The first 150 words of the full text of this article appear below.

More women in developing countries are delivering their babies in hospitals. In Latin America institutional births account for 70% of all deliveries; in Africa, 36%; and in developing countries overall some 40%.1 What is becoming apparent is that in some countries virtually all the women delivering in hospital will be surgically cut. If they miss out on a caesarean section they will have an episiotomy. For example, Brazil has caesarean section rates of greater than 30%, and Argentina has episiotomy rates of greater than 80% for vaginal births. Questions about high caesarean sections rates have been raised in the past, but unnecessary episiotomies have not been widely debated.

Obstetricians in the tropics continue to instruct health staff to apply a policy of "avoid tears-do episiotomies" routinely. They may be acting in good faith, but the evidence shows that they are wrong.4 Aiming surgically to cut all women delivering vaginally has . . . [Full text of this article]
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Relevant Article

Routine episiotomy should be abandoned
José M Belizán and Guillermo Carroli
BMJ 1998 317: 1389. [Extract] [Full Text]

This article has been cited by other articles:

  • Belizán, J. M, Carroli, G. (1998). Routine episiotomy should be abandoned. BMJ 317: 1389-1389 [Full text]  
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