Childbirth is an event which uncertainly will take place normally or not. Many changes can occur rapidly and require a proper action. One of the actions that are often performed during labor assistance is episiotomy. Episiotomy is the cutting of skin and muscle between the vagina and anus. The purpose of it is to widen the birth canal. However, recently it is revealed that this procedure should be applied selectively for appropriate indication, for example if the baby’s shoulder is stuck, the fetus is under stress so that delivery is expected to take place more quickly, deliveries assisted by forceps or vacuum, perineal muscles are very stiff, so it is likely to experience wider wounds on the perineum or labia (folds on the right and left of the vagina) if episiotomy is not performed. The purpose of this study was to analyze the effect of the evidence based use of episiotomy and non episiotomy against labor.
This study used a meta-analysis research method. The study was carried out on some of the findings from the research journals, so it is also called literature/documentation study approach. The method included in this category is Meta Analysis. Medical Practice Today emphazises the need of research scientific evidence called Evidence Based Medicine (EBM). Consequently, several studies are combined and analyzed (Meta-Analysis).
The study results showed that episiotomy should not always be performed in a normal delivery. From some research, the results are as follows: postpartum pain was more commonly occurred in women experienced episiotomy, episiotomy did not speed up the stage II labor duration in labor without complications, sexual function in women with spontaneous perineal tear or intact perineum was better sexual function in mothers experienced episiotomy or severe laceration (third or fourth degree), it may increase the incidence of perineal infection, blood loss, pain during the healing process, the negative effects on body image and sexual function, increased the risk of injury in ani sphingter, decreased hemoglobin and hematocrit and the higher rate of infection. Based on the research evidence above, it may be concluded that episiotomy should not be performed as a routine care during labor because it may increase the risk to the mother safety during labor process.Many attempts by the midwives in creating deliveries without episiotomy may be performed through antenatal care and delivery assistance, where midwives should have a belief that minimum intervention is mother friendly care to be applied in practice. During Antenatal period, midwife can create perineal elasticity through physical exercise and perineum massage. During delivery assistance, midwife should be able to carefully assess the condition of the mother and not manipulate delivery with stage II acceleration so that the risk of episiotomy and excessive perineal rupture can be avoided. Key words : Episiotomi and Non Episiotomi, Labour