| Abstract |
The origins of medical discourses about the benefits of episiotomy can be traced back to the 1920s, when episiotomy slowly gained a wider acceptance in different societies. However, the 1990s saw a transformation of the debate, including the view that episiotomy should have been regarded as an important parameter for evaluating the quality of perinatal care. Yet, this concept has not been accepted by Taiwanese obstetricians. This paper therefore strives to shed some light on the evolution of episiotomy use in Taiwan through an analysis of the existing medical discourses.
In carrying out this research, the following methods and materials were utilized: archival analysis, examination of recent notes from medical school lectures, textual analysis of medical textbooks, newspapers, and public journals, review of communication in the obstetrics community, and a field study of a Taipei regional hospital. Compared with some other countries, it appears that majority of Taiwanese obstetricians are not affected by the latest obstetric transformation, partly due to the dominance of male obstetricians, institutionalization of childbirth, and delayed childbirth movement. The “high tech” values shared by a large number of physicians make them ignore the importance of restricted use of episiotomy, which is regarded as “low tech,” but “high art” procedure.
When reviewing the history of the formation and transformation of the episiotomy discourse, it is clear that the medical paradigm of childbirth continues to be medically centered. In sum, the obstetrical practice in Taiwan needs further scientific and psychosocial assessments, in order to allow for stronger focus of the medical community on women’s health and well-being.
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