Update and Trend in Episiotomy Practice

Episiotomy is one of the most commonly practiced obstetric procedures done to enlarge the diameter of the vulval outlet to facilitate the passage for the fetal head and prevent an uncontrolled tear of the perineal tissues in the second stage of labor. Historically, the procedure was indicated to prevent third- or fourth-degree perineal tears as well as for prolonged second stage, macrosomia, non-reassuring fetal heart rate, instrumental delivery, occiput posterior position, and shoulder dystocia. Routine episiotomy is now considered to be obstetrics violence, rates of not exceeding 10% have been recommended by World Health Organization (WHO). Despite this recommendation, episiotomy is still practiced routinely in many settings

Dynamics of the Twenty-First-Century Midwifery Practice

Globally, midwifery is the safest, most cost-effective, and most satisfying method of birth assistance. This age-old profession embraces the most non-interventionist philosophy that childbirth is a natural and normal process in which the attendant merely assists in the healthy routine progression. Midwifery is commonly assumed to be all about assisting labor and childbirth, but there is more to it than that. This noble profession entails skilled, knowledgeable, and compassionate care for childbearing women, newborn infants, and families across the continuum throughout pre-pregnancy, and pre, intra, and postpartum periods. Over decades, midwifery has evolved from being informal and invisible to independent professional practice with major shifts in the scope of practice, gender, economic, and career dynamics concerning the profession. With maternal and child health being at the center of most important developments, the midwife stands out in his/her role as a primary care provider, advocate, and teacher