i'm doing a presentation on episiotomies and need ideas on what i should hand out? can't find anyhing online

Answer 1

Try to see if you can find some medical books from the library with info that you want to share with your class.

Answer 2

Look up Sheila Kitzinger's work - I think she has a book called 'Women's Experience of Childbirth,' or something very similar, and there is a chapter on episiotomies and some less-than-appealing but necessary photographs. She's a medical doctor (maybe a nurse, but I think a doctor) specialising in women's sexual issues without being strident and is much respected. She's also got another book called Women's Experience of Sex but I don't think I'm confusing the two, though if you have access to a library you may want to look at both.

Answer 3

How about a pic of the full array of tools (including a scalpel) needed for childbirth both of today and yesteryear.

Answer 4

Episiotomy
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Medio-lateral episiotomy as baby crowns.An episiotomy /ɛˌpiːziːˈɔːtʌmiː/ is a surgical incision through the perineum made to enlarge the vagina and assist childbirth. The incision can be midline or at an angle from the posterior end of the vulva, is performed under local anaesthetic and is sutured closed after delivery. It is one of the most common medical procedures performed on women, and although its routine use in childbirth has steadily declined in recent decades it is still widely practised in Latin America.

Contents [hide]
1 Uses
2 Controversy about common usage
3 Informed consent
4 Avoidance
5 References
6 External links



[edit]
Uses
Physicians use episiotomies to lessen perineal trauma, minimize postpartum pelvic floor dysfunction by reducing anal sphincter muscle damage, reduce the loss of blood at delivery, and protect against neonatal trauma. In many cases though, episiotomies cause all of these problems.

Episiotomies may be indicated if:

there is any sign of fetal distress while the baby is in the birth canal
a delivery occurs too quickly for the vagina to stretch naturally
the baby's head is too large for the opening
the baby's shoulders are stuck
it is a breech birth or forceps delivery
[edit]
Controversy about common usage
In various countries, routine episiotomy has been accepted medical practice for many years. Various urban legends circulate on the fact that after very rapid natural births, young doctors would still make episiotomies so as not to displease their professors.

Since about the 1960s, routine episiotomies are rapidly losing popularity among obstetricians and midwives in Europe and the United States. A nationwide US population study by Weber and Meyn (2002) suggested that 31% of women having babies in U.S. hospitals received episiotomies in 1997, compared with 56% in 1979. In Latin America it's still popular, where it's done on 90% of hospital births [1] and in most cases without the mother's consent. There, routine episiotomy is a major cause of infections, some of them fatal [2] .

Recent studies indicate that routine episiotomies should not be performed, as they may increase morbidity. Hartmann et al (2005), reviewing the literature, indicate that this procedure is not helpful for routine patients, though there are certain instances, such as a narrow birth canal and other problems as described above.

Having an episiotomy may increase perineal pain in the postpartum period, resulting in trouble defecating (particularly in midline episiotomies, as demonstrated by Signorello et al 2000). In addition it may complicate sexual intercourse by making it painful [3] and replacing erectile tissues in vulva with fibrotic tissue.

It has been said by some that an intact perineum serves to perform a Heimlich maneuver style move on a baby born in the normal head-first orientation. This is thought by some to expel fluid from the baby's lungs.

[edit]
Informed consent
Expectant mothers frequently make "birth plans" during their antenatal care, and are generally encouraged to discuss their views on episiotomy with their carers, or as early as possible in labour. In the final stages of delivery the midwife or obstetrician may not have time to discuss the benefits, risks and alternatives without endangering the mother or baby. However, staff restrictions or complications in labour often mean that these plans have to be altered in the course of the birth.

[edit]
Avoidance
Perineal massage with Vitamin E oil or pure vegetable oil beginning around the 34th week is an unproven way to make the perineum more flexible and reduce the need for episiotomy.

Controlled delivery of the head that allows slow gradual stretching of the perineal tissue can help in minimising damage to the perineum. In some cases an episiotomy may be required if the perineum cant stretch sufficiently and is required to help minimise damage to the anal sphincter. If the tissue is streching some studies suggest that small natural tears heal quicker and are less painful so a tear is preferrable to an episiotomy.

[edit]
References
Look up episiotomy in Wiktionary, the free dictionary.Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J Jr, Lohr KN. Outcomes of routine episiotomy: a systematic review. JAMA 2005;293:2141-8. PMID 15870418.
Signorello LB, Harlow BL, Chekos AK, Repke JT. Midline episiotomy and anal incontinence: retrospective cohort study. BMJ 2000;320:86-90. PMID 10625261.
Weber AM, Meyn L. Episiotomy use in the United States, 1979-1997. Obstet Gynecol 2002;100:1177-82. PMID 12468160.
[edit]
External links
WebMD Health – Do I need to have an episiotomy?
NotJustSkin.org – Avoiding Vaginal Tears and Episiotomies