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Created on : 02 Nov 2005
Modified on : 01 Dec 2007

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Bibliographical entry (without author) :

Episiotomy rates from eleven developing countries. International Journal of Gynecology and Obstetrics (2005) 91, 157—159.

Author(s) :

Kropp, N.; Hartwell, T.; Althabe, F.

Year of publication :

2005

URL(s) :

Résumé (français)  :

Abstract (English)  :

Researchers have questioned the continuing widespread use of routine episiotomy, after finding high rates at some centres in countries in South America, Asia, and Africa.

Systematic reviews of published trials, including a Cochrane review, have suggested that episiotomies should not be performed routinely, because of the associated maternal morbidity.

Some specialists have said that no more than 10 percent of nulliparous women delivering vaginally should need one, according to the researchers writing in the latest issue of the International Journal of Gynecology & Obstetrics.

But their study suggests that episiotomy rates are far higher than this at some hospitals. The researchers, from Uruguay and the USA, analyzed data on episiotomy rates for nulliparous and multiparous women at hospitals in Argentina, Brazil, Bolivia, Chile, the Democratic Republic of Congo, Ecuador, India, Tibet, Uruguay, Venezuela, and Zambia.

The hospitals studied (from 1 to 13 per country) were part of the US National Institute of Child Health and Human Development’s Global Network for Women’s and Children’s Health Research.


Rates above 90 percent

Reporting their findings, the researchers say that episiotomy rates among nulliparous women were higher than 90 percent in all countries except Zambia (6.9 percent).

Episiotomy rates for all vaginal births were higher than 20 percent in all countries except Zambia, and were as high as 80 percent in Brazil. The exception, Zambia, was unusual in having a lower rate for nulliparous women than for all vaginal births. The researchers, however, caution that the data for Zambia were obtained from only one hospital.

They also advise against generalizing the findings beyond the centres studied. However, they say the data “illustrate the widespread use of routine episiotomy… in contradiction to the evidence questioning its efficacy.”

Unnecessary episiotomies, the researchers write, increase the risk of morbidity as indicated by the Cochrane review, including posterior perineal trauma, the need for suturing the perineal wound, and healing complications at 7 days.

They conclude: “Strategies should be developed to decrease episiotomy rates at a global level.”

Sumário (português)  :

Resumen (español)  :

Full text (private) :

Comments :

Argument (français) :

Taux d’épisiotomies supérieurs à 90% (moyenne nationale) dans de nombreux pays pauvres.

Argument (English):

Argumento (português):

Argumento (español):

Keywords :

➡ episiotomy

Author of this record :

Bernard Bel — 02 Nov 2005