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Episiotomy – Bagatelle?

Benefit not proven

"The right to physical integrity and thus the protection of physical integrity is enshrined in the Basic Law (Article 2 (2) GG). For normal birth, the jurisdiction does not require any special clearing-up, since it represents a natural procedure. The same applies to vaginal surgical delivery and episiotomy. In most cases, the latter is performed without consent, as it is considered a standard procedure or "secondary procedure" to which the pregnant woman consents by concluding the treatment contract, although there are only a few medical indications with guaranteed benefits for mother and child. (…)"
Archive Deutsches Ärzteblatt Scroll down please.
From the comparative pilot study of the GKV 2011:
In hospitals, only 29.8% of women have an intact perineum after the birth of their child. In birth centres, 41.2% of women go home without a dam injury. (Dam injuries can also be caused by smaller or larger tissue tears, which generally heal better than cuts.) These figures have been determined for approximately 90,000 complication-free births in clinics and birth centers.

Dissertation (scientific work) by Gudrun Nitsche 2005. Comparison of the indications for a perineal cut.
1. seldom cut 
if the situation of the baby requires it = "restrictive".
2. frequently cut
when the maternal perineum threatens to tear, or the birth is to be accelerated, or time pressure prevails, or the situation of the child requires it (see 1.) = "liberal
Result: If the restrictive indication is applied, the incision rate is below 10 % (e.g. Uni-Klinik Großhadern/ Munich, as of December 2017).
The average figures for perineum injuries in Germany are unknown; according to the GKV pilot study, they were 70.2% for healthy women in 2011.

Information for delivery room
GreenBirth: The obstetric routine of an episiotomy as well as the acceleration of a birth without medical indication and demonstrable benefit are bodily injuries without necessity and without consent that violate Article 2 (2) of the Basic Law.

For your consideration:
A new guideline has been in effect since December 2020 in Germany. It applies to staff and to about 85% of women who could give birth naturally, according to WHO. They have a broad say in the matter. Use it. Ask the staff if they follow the new guidelines.
You can find out more in our ABC under G: Guidelines.

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