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Re: Mediolateral episiotomyFrom: Jane (jane.wines@ntlworld.com)Thu Sep 4 15:16:40 2003
I have been reading this thread with great interest. I am a midwife in the UK, and I have never seen a midline from either midwife or doctor, all are mediolateral. I ahve seen these women on the community and in next pregnancies, and havent seen this sagging you talk of. Cant tell if the pain is worse, as havent seen a midline to compare it to,but there doesnt seem to be much of a difference to 2nd degree tears. I would also point out that almost all episiotomies I have seen have been for forceps deliveries, midwives cut very few. I also can not think of anytime where I have seen a 4th degree tear, and I can not think this is preferable to anything. The long term morbidity for women with 3&4 degree tears is often horrendous. One poster mentioned damage from slow second stages to the nerves in the baby - I have not seen this, nor heard it mentioned as a problem of not cutting. I think that from what I have seen of the 'American' way - shoot me down if you want - is that the main difference is that our women do not labour in bed. This maybe allows the perineum to stretch in a more natural way - not achieved when in stirrups, or directed pushing with epidurals. Jane midwife UK
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