2002 Volume 16 Issue 2 Pages 56-68
The purpose of this study was to examine the occurrence of perineal lacerations in birthing homes run by Japanese midwives who are not legally allowed to perform episiotomies by law.
In this cross-sectional study, 71 women who gave normal births at a particular birthing home were interviewed based on a structured questionnaire.
Thirteen women (18.3%) had perineal lacerations while 58 (81.7%) had no perineal injuries. Amongst the injured group, all cases were first-degree lacerations ; no third-and fourth-degree lacerations were observed. On average, the disappearance of laceration pain took 4.8 days. Even with minor lacerations, the women reported feeling safe and did not feel uncomfortable. Furthermore, a lower incidence of perineal laceration was found amongst women who decided the birthing position by themselves compared with those who did not (P=0.03). Finally, perineal laceration appeared to occur less among women who were able to be recognize the lengthening of their perinea near birth, although this study was not large enough to make a stastical conclusion.
This study suggests that it is important for women giving birth to be aware of their bod ily condition near birth and to actively participate in the process of choosing their labor and delivery positions to lower the incidence of perineal lacerations. Support should be given to women so that they become aware of their bodily changes. In addition, obstetricians in most Japanese hospitals routinely perform episiotomies for “the prevention of third-and fourthdegree lacerations”, even though scientific evidence does not support the practice. This study presented, however, it is possible to undergo childbirth without episiotomies or high-degree perineal lacerations.
