Public Release: 

Health care providers should cut out painful procedure during birth

Blackwell Publishing Ltd.

Rates of episiotomy being practiced during childbirth are high, despite recommendations by prominent obstetric, midwifery, and nursing bodies to restrict the use of this procedure.

Dr. Ian Graham, a leading researcher on the topic, and his team studied rates of episiotomy around the world. They discovered that episiotomy rates vary by country as well by region. The data showed overall high rates of episiotomy, with the highest rates often found in parts of South and Central America and Asia . Among English-speaking countries, the rate is highest in the US , although there is a decreasing trend.

Rates range from as low as 9.7% in Sweden to 100% in Taiwan. In the United States, rates vary by region where in the Northeast, 38% of deliveries used episiotomy, but in the West only 27% used the practice. Rates also vary by provider within the same institutional system. A previous study in England found a large variance among midwives in the same hospital, suggesting that providers are not being guided solely by clinical indications and guidelines recommending the restrictive use of episiotomy.

Episiotomy, an invasive procedure which involves cutting a woman's birth canal at the time of delivery, has long been thought to be beneficial because it can facilitate birth, prevent perineal trauma, prevent urinary incontinence later in life, and be less painful than experiencing a spontaneous perineal tear or laceration. However, over the last two decades, research has shown that avoiding episiotomy can mean less perineal trauma, less need for suturing, and fewer complications postpartum.


This study is published in the September 2005 issue of Birth. Media wishing to receive a PDF of this study please contact

About the Author:
Ian D. Graham, PhD, is Associate Professor at the School of Nursing, University of Ottawa,and Associate Director of the Clinical Epidemiology Program at the Ottawa Health Research Institute. Dr. Graham can be reached for questions and interviews at (613) 798-5555 x18273 or

Birth: Issues in Perinatal Care is a multidisciplinary, refereed journal devoted to issues and practices in the care of childbearing women, infants, and families. It is written by and for professionals in maternal and neonatal health, nurses, midwives, physicians, public health workers, doulas, psychologists, social scientists, childbirth educators, lactation counselors, epidemiologists, and other health caregivers and policymakers in perinatal care.

About Blackwell Publishing
Blackwell Publishing is the world's leading society publisher, partnering with more than 600 academic and professional societies. Blackwell publishes over 750 journals annually and, to date has published close to 6,000 text and reference books, across a wide range of academic, medical, and professional subjects.

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