41. Damage to the anal sphincter caused by episiotomy can result in faecal incontinence ( loss of control over defecation ). 42. Last, because episiotomy speeds the pushing stage of labor, doctors believed that it would prevent injury to the baby. 43. Episiotomy is done in an effort to prevent against soft-tissue tearing which may involve the anal sphincter and rectum.44. Yet it has never been demonstrated that episiotomies do what they are supposed to do : prevent the vaginal opening from tearing. 45. At other hospitals, episiotomy is still used, but the number of procedures has declined drastically in the last 20 years. 46. The first cut, called a midline episiotomy , goes straight back and is more likely to tear into the anal sphincter. 47. Water birth offers perineal support for a birthing mother, which decreases the risk of tearing and reduces the use of episiotomy . 48. For example, the rate of episiotomies in maternity homes for primiparas was 5 % and for multiparas it was 1 %. 49. "I use forceps and vacuum, and I can't remember the last time I cut an episiotomy ," 50. However, in the past decade, studies have provided strong evidence that postpartum pain is less with spontaneous lacerations than with episiotomy .
