![]() Laine K, Gissler M, Pirhonen J (2009) Changing incidence of anal sphincter tears in four Nordic countries through the last decades. Raisanen S, Vehvilainen-Julkunen K, Gissler M, Heinonen S (2009) The increased incidence of obstetric anal sphincter rupture – an emerging trend in Finland. Revicky V, Nirmal D, Mukhopadhyay S, Morris E, Nieto J (2010) Could a mediolateral episiotomy prevent obstetric anal sphincter injury? Eur J Obstet Gynecol Reprod Biol 150:142–146 Laine K, Pirhonen T, Rolland R, Pirhonen J (2008) Decreasing the incidence of anal sphincter tears during delivery. We hypothesise that a possible consequence might be an increased incidence of obstetric anal sphincter injury. The “hands off” the perineum technique is prevalent in the management of labour. 24.4%, p = 0.001) for indications other than fetal distress. A higher proportion of midwives in the “hands-off” group would never do an episiotomy (37.1% vs. Less-experienced midwives were more likely to prefer the “hands off” (72% vs. Six hundred and seven questionnaires were returned 299 (49.3%, 95% CI 45.2–53.3%) midwives prefer the “hands-off” method. ![]() ![]() MethodsĪn observational postal questionnaire study of 1,000 midwives in England in which the main objective was to obtain an estimate of the number of midwives practising either “hands on” or “hands off” was conducted. We aimed to determine how common the practice of “hands off” the perineum is. There seems to be a temporal association between increasing use of “hands off” the perineum in labour and reduced use of episiotomy with an increasing rate of anal sphincter injuries.
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