Understanding injuries during assisted delivery

Muraca and colleagues discuss the important topic of trauma to mother and baby during operative vaginal deliveries,1 but they overlook three key points.Firstly, the severity of perineal tears has been shown to be influenced by ethnicity. In 2013, Stewart and colleagues found that women of South, South East, and East Asian origin had a higher rate of 3rd or 4th degree tears and of episiotomy than Australian born or West Asian women.2 They noted that these differences were not explained by differences in the indication for assisted vaginal birth.Secondly, the indication for forceps should be reviewed in greater detail—for example, the duration of first and second stage of labour or addition of oxytocin might influence the station of the presenting part at the time of delivery, as might the patient’s understanding of how to push during the second stage of labour.Finally, when considering training opportunities, it’s worth also considering the…
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