La episiotomía es la práctica quirúrgica mas realizada a nivel mundial. Consiste en seccionar el periné partiendo de la comisura inferior de la
vulva.
Inicialmente se describió para facilitar los expulsivos difíciles. Se le atribuyeron beneficios tanto para el bienestar neonatal como para la
prevención del daño perineal en la mujer. Su práctica se universalizo con la medicalización de los partos en la década 70-80.
Los primeros estudios epidemiológicos demuestran que su realización sistemática no presenta ventajas frente a su uso restrictivo. La OMS a principios de los 90, en sus recomendaciones para la asistencia al parto normal, estima que una tasa lógica de episiotomías rondaría Tasas de 20%.
Criticada, en ocasiones se equipara a una forma aceptada de “mutilación genital femenina”.
Los programas de mejora en atención al parto contemplan la disminución de la práctica de la episiotomía. Los profesionales se enfrentan a una nueva atención al parto sin usar está técnica.
Se impone un cambio en la atención:
- ¿Se puede disminuir el número de episiotomías?
Una de las cosas que podemos hacer es concienciarnos de nuestro periné, cómo esta, como se mueve, como relajarlo, como trabajarlo, como masajearlo. - ¿La tasa episiotomías, puede ser considerada como parámetro de calidad en la asistencia al parto?
No, porque cada caso es particular, y no siempre el realizarla depende de la atención sanitaria, si no también a la calidad muscular del propio periné. - ¿Se puede preparar el perine para el parto?
Se puede concienciar a la mujer de su propio periné, como trabajarlo y como sentirlo. - ¿Se puede prevenir el daño perineal durante el parto?
El trabajo de prevención es fundamental en la medicina moderna para intentar evitar la práctica quirúrgica innecesaria. La mejora de calidad de vida muscular se consigue con la practica de conciencia y trabajo muscular. - ¿Cuidamos el periné después del parto?
Los porcentajes de atención y cuidado del cuerpo de la madre van aumentando ya que en la sociedad hoy en día tenemos un culto y cuidado
del cuerpo cada vez mas consciente. La entrada en el mundo de la maternidad hace que la mujer olvide la importancia del cuidado de su periné. Queda camino por recorrer.
El tema es delicado, solo desde una perspectiva amplia, global y multidisciplinar se encontraran las mejores respuestas y podremos hablar verdaderamente de “SALUD PERINEAL”
Algo primordial y volvemos a Educación y Prevención. Algo que se debería enseñar desde temprana edad y quitando tabúes. El conocimiento y cuidado del cuerpo lleva a tener menos problemas de salud y utilizar menos los servicios sanitarios, algo fundamental si queremos que la Sanidad cuando sea necesario y la enfermedad inevitable pueda llegar a todos.
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