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It's time to deliver better birth care; A routine dose of antibiotics will prevent infections and pain among thousands of new mums, Jennifer Hyland learns childbirth. Gynaecologists.

Byline: Jennifer Hyland

THOUSANDS of new mums could be spared pain and long-term health problems after an assisted birth if medical guidelines are changed, research shows.

Antibiotics are currently given to women after a caesarean to prevent infections but they are not routinely given after an assisted vaginal delivery with ventouse suction cup or forceps.

Infection can hamper the healing process and even lead to long-term complications.

A study carried out by scientists at Oxford University found that giving a single dose of antibiotics after an assisted birth could halve the number of infections and prevent suffering in 7000 women in the UK and more than 200,000 worldwide every year.

It came after the Record questioned all of Scotland's health boards and found vast differences in the way procedures used during assisted births, as well as the number of women still experiencing long-term effects, are recorded.

Researchers now recommend that all women who have had a delivery with ventouse or forceps should have a dose of antibiotics to prevent infections.

Professor Marian Knight from Oxford University said: "The evidence is very clear that a single dose of intravenous antibiotic almost halves the rate of infection or suspected infection in women.

"It also has a range of other benefits. Women reported they had less pain and less need for pain relief as well as less need to consult their GP or midwife about problems with their scar.

"My feeling certainly is that the guidance should be changed."

The study, published in May, was the result of a large UK study in which women were given antibiotics after an assisted vaginal birth to prevent infection. Scientists found that antibiotics reduced the rate of infection from 19 per cent to 11 per cent, with more severe bloodstream infections reduced from 1.5 per cent to 0.6 per cent.

Chances of developing potentially deadly sepsis also fell by 41 per cent.

World Health Organisation antibiotic guidelines and other guidance from organisations in the UK, North America and Australasia do not recommend routine preventative antibiotic treatment for assisted childbirth. Following the study, the Royal College of Obstetricians and Gynaecologists said the new evidence should be considered to ensure the best possible health outcomes for women.

However, the study did not include women who had assisted births involving an episiotomy - a small diagonal cut made by a midwife or doctor from the back of the vagina, directed down and out to one side.

Under the Freedom of Information Act, the Record found there were more than 32,000 vaginal births in Scotland from January 2018 to January this year.

We requested figures for the number of medically assisted births and found that not all health boards correlated figures for how many women had deliveries involving ventouse, forceps or episiotomies.

We requested the number of deliveries involving episiotomies between January 2018 and 2019 in particular, however, only six of the 14 health boards could provide this data.

Of those that did provide figures, NHS Dumfries and Galloway said there were 799 vaginal births in the 12 months from January last year. Of them, 154 women needed an episiotomy.

A total of 216 women of a total of 716 who had vaginal births in the Borders had an episiotomy.

There were 2300 vaginal deliveries in NHS Fife, with 441 women - 19 per cent - having an episiotomy.

In NHS Lothian, 1712 of 5947 women who had vaginal deliveries needed an episiotomy while five women out of 109 who had a vaginal birth in the Western Isles required the procedure.

NHS Highland said of 1263 vaginal deliveries with 555 births needing medical assistance. From that total, 308 involved an episiotomy.

None of the 14 health boards said data was available to show how many women still experienced pain or required corrective surgery six months after having an episiotomy.

This is despite the NHS website stating that one in seven deliveries involve an episiotomy and that nine in 10 women who had an episiotomy reported that resuming sex was very painful. ? Have you been affected? Email
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Publication:Daily Record (Glasgow, Scotland)
Geographic Code:4EUUK
Date:Aug 20, 2019
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