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Lola Rovati @Lolarovati

Today, February 6, the World Day against Female Genital Mutilation is celebrated. Right away we think about the infantile ablation, an atrocity before which we all put our hands to the head, because it really is a horror that can not be believed to continue to exist.

On the other hand, an accepted practice in delivery care, such as episiotomy, does not provoke the same reaction. Of course, it is not at all comparable with ablation, at all, but the question is: could episiotomy be considered a genital mutilation?

What does the WHO say?

According to the WHO,

"Female genital mutilation (FGM) includes all procedures consisting of the partial or total resection of the female external genitalia, as well as other lesions of the female genital organs for non-medical reasons."

And adds:

"In most cases it is performed by traditional circumcisers who often have other important functions in their communities, such as attendance at birth. However, it is increasingly common for it to be carried out by health care providers. "

For its part, the WHO notes that episiotomy as a preventive technique to avoid tears is contraindicated and recognizes as acceptable an episiotomy rate of between 10% and 20% .

However, we observe that in Europe these rates are widely exceeded in most countries, with Spain leading the way with 80 percent of cases. Surely all those women did not need an episiotomy to help them give birth.

What is episiotomy?

The episiotomy is a cut or surgical incision that is made in the area of ​​the perineum of the woman, with which it is possible to extend the birth canal in the most external area to get the baby out earlier.

There are different types of episiotomy, depending on the way in which the cut is made: medial, lateral or mediolateral, the most used because it is far from the rectum and has a lower risk of tearing.

This procedure is practiced systematically, in many cases unnecessarily, without solid evidence to protect the perineum . It is also associated with a higher risk of HIV transmission, trauma and perineal tears and dyspareunia.

It is believed that it prevents tears, that a clean cut is preferable to a tear, but the truth is that there is no scientific evidence to support it. In this complete report by episiotomía.info you can find interesting conclusions arising from scientific studies on tears and episiotomy.

The cut is made, supposedly, to prevent tearing or facilitate the exit of the head when in fact there are other practices that can be performed to help soften and improve the elasticity of the perineum and thus avoid tears and episiomoties, such as women performing massages During the last weeks of pregnancy, place warm compresses during the second stage of labor and protect the perineal area manually, controlling the exit of the baby's head.

Remember that it is not a harmless cut that helps in that moment and you forget. Episiotomy can have lifelong consequences on women, both physical and psychological. There are women who have required subsequent operations to rebuild the perineum, women who end up with the pelvic floor destroyed and with serious problems to resume their sexual life.

Is episiotomy a female genital mutilation?

Having suffered an unnecessary episiotomy in my first delivery, and although you can say that "I was lucky" because according to the doctor was "a bit of nothing" (I do not want to imagine what will be a normal cut) I have had a bad time and I hope really that it is a practice that stops being used . In my other two deliveries, one of my fears was to go through the same thing again, but the rose hip massage was a saint's hand.

It's hard to think of mutilation, because it sounds strong, because they have done it to us with anesthesia, in a first-world operating room, telling us that it is for the good of our baby, and not in an African community, to know with what instrument, to shout peeling and covering our eyes.

Today more than ever is a good day to reflect on it. What do you think, can episiotomy be considered a genital mutilation?

Photo | chrisamichaels on Flickr CC More information | Childbirth is our In Babies and more | Are massage in the perineum useful to avoid tears and episiotomies? What is the effectiveness of the episiotomy during labor? Caesarean section or vaginal delivery with episiotomy?

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