Changes in episiotomy practice: Evidence-based medicine in action

Justin R. Lappen, Dana R. Gossett

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

Episiotomy during vaginal delivery was first recommended in 1920 as a way to protect the pelvic floor from lacerations and protect the fetal head from trauma. It was rapidly adopted as a standard practice and has been widely used since then. However, over the last several decades, there has been a growing body of evidence that episiotomy does not provide these purported benefits and may contribute to more severe perineal lacerations and future pelvic floor dysfunction. In this review, we examine the evidence that led to changing episiotomy practices and the debate that has surrounded episiotomy. By doing so, we can not only evaluate this specific obstetric procedure, but also gain insights into the challenge of changing medical practice as new data emerge.

Original languageEnglish (US)
Pages (from-to)301-309
Number of pages9
JournalExpert Review of Obstetrics and Gynecology
Volume5
Issue number3
DOIs
StatePublished - May 2010

Keywords

  • Episiotomy
  • Evidence-based medicine
  • Incontinence
  • Pelvic floor
  • Perineal laceration
  • Pregnancy
  • Vaginal delivery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Maternity and Midwifery

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