The First Episiotomy

The celebration of medical firsts, a rather obscure topic I'll admit, is fraught with a likelihood that we just didn't have the facts. First performing a technique, and eventually claiming that technique or publishing that technique was much like the invention of words. A new word is just a silly slip of the mouth until we all are spouting that same nonsense! So knowing really when a first occurred, might be difficult. Especially since in the prior times the female midwives did the deliveries and the male obstetricians documented them! One of the obstetrical masters of his day was one Fielding Ould, who practiced in the Rotunda hospital in Dublin in the late 1700s. He wrote the famous Treatise on Midwifery in 1742, and is credited with the first description of a cut to help a woman deliver her baby if her perineal tissues were too rigid: it was a mediolateral episiotomy. The cut was thought to be so valuable an aid to delivery the great DrLee recommended that every person should have an episiotomy in his writings around 1900, a dictum that took gynos about a century to get off of (although we had first long switched to midline cuts rather than the championed mediolateral).

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