Socio-historical evolution of the episiotomy practice: A literature review

Clesse, Christophe; Lighezzolo-Alnot, Joëlle; Lavergne, Sylvie De; Hamlin, Sandrine; Scheffler, Michèle

doi:10.1080/03630242.2018.1553814

Cited by 17 publications

(17 citation statements)

References 54 publications

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“…Although routine prophylactic episiotomy was performed during the 1980s to the mid-1990s, concerns on the potential complications associated with episiotomy arose during this period. 1 Since 1996, a large volume of literature has concluded that routine episiotomy is unnecessary and may even increase the risk of 3 rd or 4 th degree perineal laceration. 2 , 3 , 4 The World Health Organization (WHO) and other professional societies recommended restrictive over routine episiotomy since 1990s, although no ideal rate of episiotomy is suggested.…”

Section: Introductionmentioning

confidence: 99%

A nationwide cross-sectional survey of episiotomy practice in China

Chen

Yang³

et al. 2022

The Lancet Regional Health - Western Pacific

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Background A restrictive use of episiotomy was recommended by the obstetric society in China, but limited information on the epidemiology and the effects of restrictive use of episiotomy on maternal and fetal outcomes have been published. MethodsThe China Labor and Delivery Survey is a cross-sectional investigation with a cluster random sampling scheme in 2015-2016 with the aim to describe detailed epidemiology of labor and delivery in China. We calculated the episiotomy rate by parity using the survey data. Associated factors of episiotomy were selected using mixed models with a random effect for the hospital-level clustering. Logistic regression models were fitted to examine the effects of mediolateral episiotomy on maternal and neonatal outcomes among the propensity score-matched women.Findings The episiotomy rate among vaginal births was 41¢7% [95% confidence interval (CI): 40¢1% -43¢2%] in nulliparae and 21¢5% (95% CI: 19¢4% -23¢5%) in multiparae in China. Associated factors of episiotomy included prepregnancy BMI, maternal diseases, and obstetric factors. More than half of episiotomies in nulliparae and onefourth in multiparae had no indications. Mediolateral episiotomy without indicators increased the risk of 3 rd or 4 th degree perineal laceration [odds ratio (OR) =2¢64, 95% CI: 1¢08-6¢48)] in nulliparae without neonatal benefits.Interpretation Episiotomy was performed more than medically necessary in China. Mediolateral episiotomy without indications more than doubled the risk of 3 rd and 4 th degree perineal laceration in nulliparae without neonatal benefits.

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Section: Introductionmentioning

confidence: 99%

A nationwide cross-sectional survey of episiotomy practice in China

Chen

Yang³

et al. 2022

The Lancet Regional Health - Western Pacific

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“…Con el fin de caracterizar la práctica de la episiotomía se comienza por una revisión bibliográfica de diversos informes llevados a cabo por organismos internacionales -la ONU o la OMS-a los que se añaden estudios clínicos y estadísticos en obstetricia, matronería y enfermería. Apoyándose en ellos, la autora constata que la episiotomía sigue constituyendo una práctica habitual en gran número de países tanto europeos como latinoamericanos (Clesse et al, 2019), con porcentajes muy por encima de los recomendados, sin una prueba clara de sus beneficios y con variaciones tanto en las categorías de madres a las que se aplica, debidas a la etnicidad, como a la modalidad de parto, en casa o en el hospital. Su definición de esta práctica desde la perspectiva de género lleva a la autora a considerarla una técnica disciplinaria normativizada desde el biopoder (Foucault, 1998) y un buen ejemplo de las múltiples violencias contra las mujeres.…”

Section: Investigaciones Feministasunclassified

Presentaci´ón. La maternidad es persona y política. Construyendo un nuevo discurso en torno a las maternidades

Hernández

2020

Inv. fem.

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“…Finally, combining an epidemiological and sociohistorical approach, Clesse et al (2019) compared the evolution of episiotomy rates worldwide and the factors associated with its generalization and decline. Regarding the French context, they hypothesized that the spread of episiotomy in the 1980s and 1990s ‘was intrinsically linked to the medicalization and institutionalization of birth’ and to ‘[the] cultural influence of the USA and its associated perceived scientific standing’ ( Clesse et al, 2019: 6 ), which favoured the introduction of episiotomy as a routine procedure.…”

Section: Introductionmentioning

confidence: 99%

Ignoring international alerts? The routinization of episiotomy in France in the 1980s and 1990s

Mirouse

2022

Reproductive Biomedicine & Society Online

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As scientific evidence from the UK and the USA in the 1980s was questioning the usefulness of episiotomy, the rate in France increased from 38% in 1981 to 58.4% in 1996. In 1996, the World Health Organization recommended limiting the episiotomy rate to 10%. This article aims to examine this paradox through an analysis of the French medical debate on episiotomy during the 1980s and 1990s. Drawing on an analytical corpus composed of 192 articles published in French professional journals of obstetrician-gynaecologists and midwives, it shows that the majority of these health professionals considered episiotomy to be a preventive intervention. The most influential professional organizations and experts manage to refute most of the international alerts on the limitations and side effects of episiotomy through the constant production of new justifications and competing knowledge for the procedure. In the 1980s, episiotomy was seen as a means to prevent tearing and thus avoid perineal dysfunction. Episiotomy and perineal re-education (which developed into a new health sector) were put forward as ‘the’ solution to the problem. From the mid-1990s onwards, the focus shifted from the mother to the baby as episiotomy was promoted as a way to reduce the risk of newborn mortality and morbidity. This article shows that the alerts and controversies on the assumed iatrogenic effects of biomedical technologies and practices were silenced through efficient and dynamic production of competing knowledge about their assumed benefits.

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Socio-historical evolution of the episiotomy practice: A literature review

Cited by 17 publications

References 54 publications

A nationwide cross-sectional survey of episiotomy practice in China

A nationwide cross-sectional survey of episiotomy practice in China

Presentaci´ón. La maternidad es persona y política. Construyendo un nuevo discurso en torno a las maternidades

Ignoring international alerts? The routinization of episiotomy in France in the 1980s and 1990s

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