Routine Episiotomy and Pelvic Symptomatology

Abstract

Fifty women who had routine midline episiotomies with their previous delivery were matched with 50 women who had not. Matching was with regard to age, socioeconomic status, parity, current pregnancy status, current nursing status, and length of time since previous deliveries (equivalent child spacing). All women were at least one year postpartum. All women had had normal pregnancies and deliveries with vertex presentations. Comparisons between the two groups 1-13 years after delivery yielded few statistically significant differences in symptoms and signs of pelvic relaxation, findings of clinical examination, and results of measurements of pubococcygeal muscle tone and strength with Kegel's perineometer. Regression analysis showed that both episiotomies and lacerations made significant contributions t o symptoms and signs of pelvic relaxation and discomfort. Kegel exercises appeared to help prevent such symptoms when done during pregnancy and after the first three months postpartum, but not when done only immediately postpartum. Other findings of note include the contribution of gravidity, parity, hair color and skin complexion, and time. Birth weight was not significant and all infants weighed from 5 to 9 pounds. These findings are discussed in reference to clinical practice and the direction of further research.