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Episiotomy and the Second Stage of Labor

Allan G. Charles, MD
JAMA. 1985;253(12):1800. doi:10.1001/jama.1985.03350360126039.
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Episiotomy and the Second Stage of Labor, by Kitzinger and Simkin, is an interesting book. The authors' bias against episiotomy is evidenced by the illustration on the book cover, a primitive figurine of a woman delivering a child with a large, open pair of episiotomy scissors spread threateningly behind the figurine.

In an era in which alternative birth methods are being offered and in which some basic obstetrical tenets are being questioned, books such as this should at least be read by conscientious practicing obstetricians.

In an introductory chapter Kitzinger mentions a survey conducted by the Natural Childbirth Trust on experiences with episiotomies. Nowhere does she state how many women were interviewed or how the sample was chosen. She does state, however, that there were disturbing findings, among which was painful episiotomy. I would question the statement that "an episiotomy done early on a thick perineum, of course, increases pelvic


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