Routine episiotomy should be abandoned

BMJ 1998;317:1389 ( 14 November )

Letters

Routine episiotomy should be abandoned

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

EDITOR $---$ In their editorial Maduma-Butshe et al discussed the need to abandon the routine use of episiotomy in developing countries.¹

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The use of episiotomy is a paradigmatic example of the many interventions that are introduced into clinical practice withoutscientific evidence and found after well performed research tobe not only unjustified but also possibly harmful.² In addition,once an intervention has been established in clinical practiceit is not easily abandoned, even when strong scientific evidenceshows its uselessness andharmfulness.

We have presented the results of our study on episiotomy³ and the reviews about it ² ⁴ many times, but clinicians haveoften remained sceptical and expressed little desire forchange.

The table shows the trend in the use of episiotomy in one of the hospitals where the Argentine episiotomy trial was performed(Maternidad Martin, Rosario, Argentina).³ Overall rates ofepisiotomy changed from 47.9% before the trial to 28.4% . . . [Full text of this article]

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