Evidence Based Birth® REPLAY: EBB 206 - Evidence on Perineal Tears and the Importance of Avoiding Episiotomy with EBB Founder, Dr. Rebecca Dekker
Apr 30, 2025
Explore the critical conversation around perineal tears and the importance of avoiding episiotomies. Learn about different types of tears and factors impacting their risk. Discover the historical context of episiotomies and why routine use can lead to adverse outcomes. Hear about the empowering role of advocates in childbirth and the necessity of informed consent. Engaging insights aim to empower listeners to advocate for better maternal care and understand their bodily autonomy during the birthing process.
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First Birth Raises Tear Risk
- First-time vaginal births greatly increase the risk of severe tearing.
- Subsequent births have much lower rates of severe tears, sometimes under 1%.
Factors Raising Severe Tear Risk
- Risk factors for severe tears include: first birth, high baby weight, instruments used (forceps/vacuum), episiotomy, shoulder dystocia, and abnormal pushing durations.
- Sunny side up fetal position and family history also increase tear risk.
Health Consequences of Tears
- Tears commonly require stitches, and many birthing people experience moderate to severe pain postpartum.
- Long-term issues may include pain during sex and incontinence; postpartum depression and inflammation also rise with severe tears.
