Fantastic review of the available data. I am concerned about the tone used to describe the supposition that a doctor’s and/or midwife’s need to do something with her hands plays a role in perineal massage and the decrease in episiotomy rate. I agree that this is a very likely possibility, however the desire to do something with one’s hands is coming usually from a place of wanting to do good. Using a negative tone may alienate the very listeners (doctors/midwives) whom you wish to have an impact on in changing practice. Perhaps a slight change in wording could change the tone, and thus be more palatable to professionals in the field. I hesitate to share this very important episode with my colleagues for this reason.
Maybe share and let people decide for themselves? As a birth worker, I am open to the truth regardless of tone. And I think we all need to work towards understanding the message and leaving our egos out of it. I think that’s a big problem we have today - people being critical of the tone, taking things personally, becoming defensive, and discounting the very important message because they feel attacked or triggered by the tone.
I don't recall feeling my Perineal Massage aside from a bit of stretching, it reassured me a lot that they tried gentle ways to ease everything though, especially since I had a very fast delivery. I didn't need any stiches so I probably wasn't at risk of having 3 or 4 degree tears
I wonder if the studies in Iran are affected by the rate of patients with female genital mutilation in the hospital. I imagine that would affect the rate of episiotomy.
