Episiotomy

Dayray, RN · Jul 8, 2005

Because of litigation matters, most OB's will perform episiotomy to try and prevent pelvic floor relaxation issues and/or rectocele/cystocele matters later on. Many suits are secondary to the fact that the injury might have been avoided had an epsiotomy been performed . Also, some suits have proven that had the epsiotomy been performed, the infant would not have had neurological problems later. I agree, the procedure may not be acceptable in EVERY case, but, physician's are litigation-aware now.

huh?

Sorry but i havent seen any research showing that epsiotmy reduces pelvic floor problems. Could you please list your sourse of this information?

sddlnscp · Jul 8, 2005

do NOT let it depress you! more and more doctors and midwives are taking the "wait and see" attitude I discussed earlier. Routine episiotomies are becoming very much
"not in vogue" with the newer generation of practioners. Read again, the responses that say we can count on one hand the number of times in years we have seen an epis cut for no good reason, and take heart. Things are changing. And no woman is powerless; she has the right to informed consent for any intervention and procedure and this would include cutting an episiotomy!!!!

Thank you - this makes me feel much better. I guess I need to always remember that there are a lot of good doctors out there - mine, for example - and . . . he is a much older doctor, so that has to be a good thing! :) I did go back through and re-read the posts and that helped - I just have to keep in mind that, no matter how much we dislike it, there are always going to be people who do things we don't think they should. Rats. Oh well - I will keep a positive attitude and commend those that do what is best for their patients regardless of what is easiest on them. Oh I cannot wait to be a nurse!!! Thanks again!

SmilingBluEyes · Jul 8, 2005

You are welcome Sarah. I am not trying to paint an all roses picture for you, but I do want you to take heart and encourage you. Good luck in your studies.

sddlnscp · Jul 8, 2005

Thanks - I'll take encouragement any day.

SmilingBluEyes · Jul 8, 2005

Well that is what i am here for. Anytime you need help, just ask.

sddlnscp · Jul 8, 2005

Hehe - you can count on that - hopefully you won't be sorry.

RNnL&D · Jul 9, 2005

Only one of our docs cuts epis's routinely (a young female DO, at that). A couple others who do epis more than I like, and the rest very rarely do.

The only 4th degree lacs I have seen, have all been epis extensions.

UTRN2005 · Jul 10, 2005

And no woman is powerless; she has the right to informed consent for any intervention and procedure and this would include cutting an episiotomy!!!!

Ok, Student here with very little OB experience, although I just finished my rotation in it. I fully understand informed consent, however in both vag deliveries I saw that included epis, the epis were just cut...No consent, no paperwork, no discussion that the OB was even going to cut an epi. They just grabbed the scissors and cut. Then one of them told the RN it was a lac not an epi, when I saw him cut it. I love babies and had a brief moment of thinking I might want to do OB but I would not be able to work in a facility that was as big on intervention as the hospital I rounded to was.

Just my limited experience.

BETSRN · Jul 10, 2005

Ok, Student here with very little OB experience, although I just finished my rotation in it. I fully understand informed consent, however in both vag deliveries I saw that included epis, the epis were just cut...No consent, no paperwork, no discussion that the OB was even going to cut an epi. They just grabbed the scissors and cut. Then one of them told the RN it was a lac not an epi, when I saw him cut it. I love babies and had a brief moment of thinking I might want to do OB but I would not be able to work in a facility that was as big on intervention as the hospital I rounded to was.
Just my limited experience.

Sadly, you will learn that docs call things what they want just to cover their butts. Hopefully, the nurse saw what he did. If I saw that, I would question the doc after.

SmilingBluEyes · Jul 10, 2005

Sadly, you will learn that docs call things what they want just to cover their butts. Hopefully, the nurse saw what he did. If I saw that, I would question the doc after.

ITA.

mandykal, ADN, RN · Jul 10, 2005

I was wondering how others felt about the issue. I'm an lpn student, graduating this aug, currently in my ob rotation. I assisted in a lady partsl delivery today, and as soon as the head crowned, the Dr's did an epiosiotomy. I felt like they didn't even wait to see if it was necessary. Are dr's too quick to do this procedure nowadays? I feel like it's way too commonly done. I do a lot of reading up on the whole birthing process b/c I want to become a CNM.

If you're still in your ob rotation, the next time you see the doctor do a episiotomy or your peers, ASK HIM AFTER; "what are his findings for him to determine that procedure is necessary?"...Or why just ask him when you see him.

It makes me wonder if they just want the baby out quickly....You know that feeling when your job becomes a routine and you loose that feeling of interest......It happens..