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LETTERS: José M Belizán and Guillermo Carroli Routine episiotomy should be abandoned BMJ 1998; 317: 1389 [Full text]

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"And the costs ?"

Paul Tolck   (16 November 1998)

Are we in a haste?

Suresh Deshpande   (17 November 1998)

"And the costs ?" 16 November 1998
Paul Tolck, Serv. gyn.-obst. Hospital Send response to journal: Re: "And the costs ?"	In Switzerland, in general, the price for a delivrery is same with or without an episiotomy. We spend more time to deliver and to repair an episiotomy...then why a such intervention ? Time is money ! Is it possible to know a publication where the weights and the skull perimeters are considereted with the size of the mothers ? How many are torn perineums ? How much time is spend to repair a torn perineum to compare with an episiotomy repair ? Thank you. Dr Paul Tolck Serv. de Gyn-Obst. Hôp. Chasseral 20 2300 La Chaux-de-Fonds CH
Are we in a haste? 17 November 1998
Suresh Deshpande, Consultant, Ob-Gyn Pune, India Send response to journal: Re: Are we in a haste?	Sir, I think the discussion started with the non-scientific enquiry with residence of foreign origin, presenting anectodes from far reaching lands. That article deserves no comments, except why it was published. When statistics are presented about deliveries in third world countries, one absolute must is to have a count of women, who delivered without episeotomy, and some qualified doctor certifying that there is no perineal tear. It is an accepted rule that cutting with scissors is better than cutting with foetal heads. Perhaps, one has to consider the transition of health of mother to foetus, as far nutrition, physical parameters and strength are changing. This generation gap burdens both the participants with special concessions. This may not have any value in the minds of settled British assessors. Dr Suresh Deshpande, 33/15, B, Karve Road, PUNE 411 004, INDIA.