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Re: Mediolateral episiotomy From: Charlie Chambers (cchamber@gorge.net) Thu Sep 4 16:57:20 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Michael J. Wolpmann, MD: "Mirena IUD with Continuous ERT?" Previous message: Charlie Chambers: "Re: New record set" In reply to: Jane: "Re: Mediolateral episiotomy" Jane, you made have some valid points. I do believe the "American way" has strayed away from stirrups deliveries though some exceptions still exist. Certainly, studies have shown the increased risk of 3rd and 4th degree lacs with stirrups, forceps, and episiotomies of all kinds. The generalization of who cuts more episiotomies may be a little presumptuous. I've seen both midwives, and M.D. cut many or none. On Thursday, September 4, 2003, at 01:20 PM, Jane wrote: > 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 > ************************************************************************ **** Charlie Chambers -- Hood River, OR cchamber@alumni.rice.edu "Almost anything you do will seem insignificant but it is very important that you do it....You must be the change you wish to see in the world" -- Mahatma Ghandi. ************************************************************************ ******* Next message: Michael J. Wolpmann, MD: "Mirena IUD with Continuous ERT?" Previous message: Charlie Chambers: "Re: New record set" In reply to: Jane: "Re: Mediolateral episiotomy"

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