Captain Obvious on Episiotomies and Cesareans?

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By Jill Arnold


I think I am the last person on whom it dawned that maybe one of the reasons there are fewer episiotomies performed today than a decade or so ago is that there are fewer opportunities to do so as a result of the increase in the number of cesareans. I always assumed the downward trend could primarily be attributed to the reason given in the notes:
Episiotomies are performed to assist or speed delivery and/or prevent trauma to the mother.  They were performed fairly routinely, but lack of clinical evidence of benefits and some indication of increased injury from the procedure has led to decline in the use of the procedure.
If you have fewer vaginas on which to perform episiotomies, you will probably perform fewer episiotomies. And probably perform more suprapubic episiotomies. Or maybe you’re just performing more repairs on obstetric lacerations as noted and fewer episiotomies.