Many of the women who undergo an episiotomy while giving birth were not asked by medical staff for permission to do so, according to new research by Amsterdam teaching hospital researcher Marit van de Pijl.  

Van de Pijl looked at the experiences of over 11,000 women who answered an online survey about medical intervention while giving birth to fine out if they had been asked permission in advance.

In total, nearly 42% of the women who had undergone an episiotomy said they had not been asked for permission while 43 said they had been cut open, despite refusing to allow it.

In addition, 47% of women said they were given a drug to speed up the placenta being expelled without being asked and 41 were given oxytocin despite saying no. 

Not all the women regarded the lack of permission as a problem but most did. “Each patient is different but it is important that a woman knows what is happening to her and her baby during the birth process,” Van der Pijl told broadcaster NOS. “Good communication is essential.” 

An episiotomy involved cutting into the perineum to give a baby more room to emerge. The aim is to prevent more serious tearing and allow a baby to be born more quickly if it is in trouble. 

Healthcare workers are required by law to ask patients for permission for each medical treatment, a process known as “informed consent”. 

“We know that healthcare workers do their best and we cannot conclude why things so often go wrong from this research,” Van der Pijl told NOS. 

Some 20% of the women in the survey gave birth at home and 65% had no pain relief.

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