Update and Trend in Episiotomy Practice

Abstract

Childbirth is one of the most magical moments in life. Since it is such a special moment, there is a lot of expectation and sometimes a lot of frustration. Delivery assistance is a major challenge today. Safety in childbirth care to avoid maternal-fetal morbidity and mortality is especially important. It is vital to avoid, on one hand, the excess of medicalization with early and unnecessary interventions and, on the other hand, the lack of care that can lead to a delay in decision making. In this delicate balance, it is also important to take into account the expectation of the parturient with her desires related to how the birth she idealized will happen. Respecting her wishes without putting the maternal-fetal binomial at risk is a great challenge for the obstetrician. The setting where the delivery will occur should be prepared by a sensitive, respectful and kind staff. It is important to avoid interventions as fundal pressure, routine episiotomy, and the excess of unnecessary caesarean section. Cultural, socio-economical aspects and choosing the delivery mode are part of a big puzzle. This book aims to assess the best childbirth care among the scientific evidence. Good quality care is essential for maternal and fetal safety. The book will cover the routes of delivery such as spontaneous vaginal birth, operative vaginal birth and caesarean section. The chapters will address the following topics: setting (respectful maternity care, effective communication, companionship during labour and childbirth), labour progression (definition and duration of the latent and active first stages of labour, progress of the first stage of labour and second stage of labour), pain relief during labour, prevention of postpartum haemorrhage (third stage of labour), assessment of pelvic floor (episiotomy, obstetrical anal sphincter injuries -OASIS, Epi-no and perineal massage), care of the newborn (the golden hour of the neonatal life) and puerperal care (breastfeeding and puerperal depression). BT - Childbirth