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Episiotomies may cause problems, not help

The January 8, 2000 issue of the British Medical Journal reports that women who receive episiotomies during the delivery process are more likely to develop anal incontinence (a loss of bowel control), something the episiotomies are supposed to help prevent. Nearly one third of the three million or so women who give birth in the U.S. have the procedure performed, many of which are done routinely rather than as needed. Episiotomy involves cutting the muscles between the vagina and the rectum, ostensibly performed to keep the muscles from tearing. This was supposed to help prevent damage to the anal sphincter which can lead to a loss of bowel control. Three groups of women were studied; those who had episiotomies, those who experienced a tear of the muscle and those who remained intact. "About 10 percent of women with episiotomies were experiencing fecal incontinence three months after giving birth," the researchers say. "Women in the 'tear' group and the intact group had less than half that risk. " Six months after delivery, all groups reported less incontinence but it was still twice as common in the episiotomy group. The study went on to say that the extra risk for the loss of bowel control had nothing to do with any other complications of labor such as the mother's age, baby's weight, length of labor or use of extraction devices.

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