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Is prevention always the best cure?(Brief Article)

Publication: Midwifery Today

Publication Date: 22-MAR-03

Author: Wickham, Sara
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COPYRIGHT 2003 Midwifery Today, Inc.

Without having read the other articles in this issue of Midwifery Today, I feel fairly confident that a number of my midwife friends will have written brilliant articles sharing tips, tricks and ideas for preventing perineal tears. And I am very glad they have; it is always good to learn new ways of helping women through birth.

Yet, I'm wondering whether "tear prevention" is as important a goal as we think. Given that I believe we should be ready to question even the most sacredly held of our practices, I've been giving some thought to what lies behind the ideal of tear prevention. Is a high intact perineum rate an unequivocally noble goal and the mark of a "good" midwife (as we have generally come to believe)? Or does tear prevention constitute another set of interventions that may be beneficial to individual women, but not necessarily all women? Its routine use should be carefully reflected upon and questioned with the aim of improving our practice.

The Perineum in Nature and Culture

We hear and read a lot these days about the need to focus on physiology and "normal birth." Yet,...

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