title: How to perform an episiotomy.
abstract: RATIONALE AND KEY POINTS: An episiotomy may be necessary to assist some women to give birth. An episiotomy is a surgical incision intentionally made to increase the diameter of the vulval outlet to enable childbirth. ▶ Midwives and doctors should use their clinical judgement and skills to assess when to perform an episiotomy. ▶ An episiotomy should not be performed routinely; its use should be restricted to certain indications. ▶ Adequate pain relief should be provided before performing an episiotomy. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How you think this article will change your practice. 2. The risk factors that can predispose a woman to having an episiotomy. 3. What you would do if a woman refused to have an episiotomy despite the presence of a clinical indication, such as fetal distress. Subscribers can upload their reflective accounts at: rcni.com/portfolio.
authors: School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide, Australia.
authors: Mary
authors: M
authors: Steen
authors: Women's and Babies Division, SA Health, Government of South Australia, Adelaide, Australia.
authors: Bernie
authors: B
authors: Cummins
mesh_terms: D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000379:methods* / Q000451:nursing; D004841:Episiotomy / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000451:nursing; D011247:Pregnancy; D012307:Risk Factors
keywords: childbirth; clinical procedures; clinical skills; episiotomy; intrapartum care; midwifery practice; perineal wounds; surgical incision