Common Procedure During Delivery May Do More Harm Than Good

Eleven years ago, Jason Damico was born a healthy and happy baby, but his mom, Diane, had problems after delivery.

"I had a lot of pain," Damico said.

After a long labor, Damico's doctor performed an episiotomy. It is an incision used to hasten delivery and prevent tearing, but it caused problems for her.

"It took a very, very long time to recover and had two reconstructive surgeries after that," she said.

Episiotomies may be needed when the baby is in distress, but UNC researchers say episiotomies may be too routine.

"Women are having equivalent outcomes without an episiotomy," said UNC researcher Dr. Katherine Hartman.

Hartman said many doctors prefer stitching together a clean incision rather than repairing a tear, but some incisions can cause other problems, including rectal incontinence, urinary incontinence and sexual disfunction. Hartman said without an episiotomy, a third of women will not have a tear that requires stitches.

"When there is a spontaneous tear, the outcomes are very similar to the episiotomy, so they're not providing benefit," Hartman said.

Hartman recommends women meet early with their doctor to discuss their preferences at the time of delivery. It is a discussion Damico never had.

"I wished that I had spoken with him prior to that event because it's very difficult to make decisions when you're right there ready to deliver your baby," she said.

It is important to discuss the issues with your prenatal care provider as early as possible, not just about an episiotomy, but also your preferences concerning an epidural and other pain medication.