Episiotomy vs. tearing in childbirth

Abstract

Over the past century, the use of episiotomies during childbirth have been common. Recently, practitioners began questioning whether the use of episiotomies caused more negative patient outcomes than allowing a laboring woman to tear naturally. This literature review synthesizes research on patient outcomes following an episiotomy compared to tearing naturally during labor. The clinical question is: "Does allowing laboring mothers to tear naturally during childbirth increase positive patient outcomes compared to the use of episiotomies?" This is a translational research study utilizing a literature review design. All authors have comopleted the National Institute of Health (NIH) Office of Extramural Research's online training, "Protecting Human Research Participants," this semester and hold current certification. After rigorous review and proven critical appraisal of over twenty current research studies, the use of episiotomies were found to have many negative effects on mothers postpartum. These effects included, but were not limited to: delayed healing time, increased degree of laceration, increased risk of infection, increased blood loss, and disturbed family bonding. Consistently, each article concluded that the routine use of episiotomies caused more adverse effects and that laboring mothers should be allowed to tear naturally. However, episiotomies should be used in extreme circumstances that include the threat of life to the fetus due to imminent delivery.