Are routine interventions necessary in normal birth?

Taiwan J Obstet Gynecol. 2006 Dec;45(4):302-6. doi: 10.1016/S1028-4559(09)60247-3.

Abstract

Routine interventions during labor and birth, such as perineal shaving and enemas before vaginal delivery, continuous intrapartum electronic fetal monitoring (EFM), and episiotomy are prevalent in Taiwan, but they may not always be necessary. Numerous studies investigating these interventions have failed to find absolute benefits for women with uncomplicated and low-risk pregnancies. No evidence-based benefits support routine perineal shaving or enemas during labor for reducing the risk of perineal wound infection or neonatal infection. The use of EFM is associated with an increased rate of operative interventions (vacuum, forceps, cesarean delivery) but does not result in a significant decrease in the incidence of perinatal death or cerebral palsy. Routine episiotomy does not have demonstrable advantages over restrictive episiotomy in the frequency or severity of perineal damage or pelvic relaxation.

Publication types

  • Review

MeSH terms

  • Delivery, Obstetric / methods*
  • Enema* / statistics & numerical data
  • Episiotomy* / statistics & numerical data
  • Female
  • Fetal Monitoring* / adverse effects
  • Fetal Monitoring* / methods
  • Fetal Monitoring* / statistics & numerical data
  • Humans
  • Pregnancy
  • Taiwan