Essentials of Maternity, Newborn, and Women's Health Nursing by Susan Ricci

Author:Susan Ricci [Ricci, Susan]
Language: eng
Format: azw3
ISBN: 9781496368416
Publisher: LWW
Published: 2016-08-21T16:00:00+00:00

Take Note!

Restrictive use of episiotomy has been recommended by ACOG given the risks of the procedure and unclear benefits of routine use (Friedman et al., 2015).

The midline episiotomy has been the most commonly used one in the United States because it can be easily repaired and causes the least amount of pain. The application of warmed compresses and/or intrapartum perineal massage is associated with a decrease in trauma to the perineal area and reduced the need for an episiotomy (Green, 2016). Routine episiotomy has declined since liberal usage has been discouraged by ACOG, except to avoid several maternal lacerations or to expedite difficult births Anal sphincter laceration rates with spontaneous vaginal delivery have decreased, likely reflecting the decreased usage of episiotomy. The decline in operative vaginal delivery corresponds with a sharp increase in cesarean births, which may indicate that health care providers are favoring cesarean births for difficult births (Faisal-Cury et al., 2015). Figure 14.14 shows episiotomy locations.

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