More study updates for you….
The Royal College of Obstetricians and Gynaecologists (RCOG) have just updated their guidelines for management of 3rd and 4th degree tears. The last update was in 2007 so, in light of the study published and discussed in my last post, I think this update was well overdue.
I’m sorry to report that the RCOG knows no more than me about the risks of recurrent severe tears. However, it is very reassuring to see that their advice re episiotomies is up to date (i.e. that an episiotomy brings no benefit in reducing tears unless an instrumental delivery is being carried out). Also, they are quoting studies that reveal the benefits of a warm compress and hands on approach which is very interesting.
The support forums that drew my attention to this new study are skeptical about the RCOG claim that the increased incidence of severe tears in the past ten years relates to better detection rather than poorer quality of care. I’ll let you draw your own conclusions….