![]() Montalvo, speaking in general terms, said, “An episiotomy is done at that moment when it’s needed - it’s not like we did it because we wanted to. Eliud Acevedo, did not respond to requests for comment, and the hospital said it would not comment on individual cases. “I do remember signing, but I honestly don’t remember what they said because I was already in labor,” said Martinez, now 20. She said that although she’d signed a general consent form when she had arrived at the hospital the day before, she was not told why the episiotomy was being performed or the risks and benefits.īy the time the doctor made the incision, she’d been having contractions for more than a day, was on pain medication and had eaten nothing but ice chips. But it gnaws at her that neither the procedure nor its potential long-term consequences were explained to her ahead of time. Martinez delivered a healthy baby boy and has suffered no serious complications. The reduction in episiotomies at Doctors Hospital was driven by a requirement that hospitals meet state-designated standards for maternal care in order to qualify for Medicaid reimbursements starting next September. The state of Texas, which collects data on hospital procedures, has not yet made statistics for 2020 available. The hospital did not provide its data to the Express-News, however. Juan Montalvo, said the hospital significantly reduced the frequency of episiotomies this year - from 34 percent in December 2019 to 14 percent by summer. “Although guidance from the American College of Obstetrics and Gynecology has evolved over time, valid reasons remain for why physicians perform the procedure,” the hospital said.ĭoctors Hospital of Laredo is a 183-bed, for-profit institution partly owned by the physicians who practice there. The 326-bed Laredo Medical Center, the city’s largest hospital, told the Express-News in a statement that it’s working with its obstetricians to review internal data on episiotomy rates. “When a woman comes to a certain point in pushing the baby out, in many cases you could either continue to let her push for another half hour - or cut an episiotomy, deliver right now and you’re done.” Steven Clark, a professor of obstetrics and gynecology at Baylor College of Medicine in Houston who has spearheaded efforts to reduce episiotomies. “If you get to the core of the matter - why on earth are doctors performing episiotomies unnecessarily? It’s impatience,” said Dr. There is no national standard for episiotomies, but the Leapfrog Group, a national nonprofit that analyzes data on hospital safety and quality of care, recommends a rate of no more than 5 percent. Try an upright or side birthing position rather than lying on the back or in stirrups.Place a warm compress on the perineum during the second stage of labor.Massage or support the perineum during the second stage of labor (when a mother begins pushing).Massage the perineum starting at 34 weeks of pregnancy.The American College of Obstetricians and Gynecologists says these strategies have been used to avoid tears during childbirth: But evidence accumulated that they can do more harm than good, causing intense pain and the potential for serious long-term complications including loss of bladder and bowel control. performed them in more than 60 percent of vaginal births. The first-time mother, then 19, feared the stitches would suddenly split apart: “I was really scared to go to the restroom - like really scared,” she said.Įpisiotomies were once commonplace. ![]() ![]() She described it as 8.5 on a scale of 10. Nothing could have prepared her for the pain she experienced after birth, she said. “They just made it seem like, ‘Oh it’s just a little thing, a little snip and that’s it,’” Martinez said of the medical staff who handled her delivery in September 2019. Learn more about these measures and how you can use them to talk with your medical provider. Have you recently given birth or have a story to share? Help us continue investigating maternal health care by filling out this questionnaire.
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