{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:08:32Z","timestamp":1791724112750,"version":"4.3.4"},"reference-count":13,"publisher":"BMJ","issue":"6445","license":[{"start":{"date-parts":[[1984,9,8]],"date-time":"1984-09-08T00:00:00Z","timestamp":463449600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1984,9,8]]},"abstract":"<jats:p>One thousand women were allocated at random to one of two perineal management policies, both intended to minimise trauma during spontaneous vaginal delivery. In one the aim was to restrict episiotomy to fetal indications; in the other the operation was to be used more liberally to prevent perineal tears. The resultant episiotomy rates were 10% and 51% respectively. An intact perineum was more common among those allocated to the restrictive policy. This group experienced more perineal and labial tears, however, and included four of the five cases of severe trauma. There were no significant differences between the two groups either in neonatal state or in maternal pain and urinary symptoms 10 days and three months post partum. Women allocated to the restrictive policy were more likely to have resumed sexual intercourse within a month after delivery. These findings provide little support either for liberal use of episiotomy or for claims that reduced use of the operation decreases postpartum morbidity.<\/jats:p>","DOI":"10.1136\/bmj.289.6445.587","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"587-590","source":"Crossref","is-referenced-by-count":330,"title":["West Berkshire perineal management trial."],"prefix":"10.1136","volume":"289","author":[{"given":"J","family":"Sleep","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Grant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Elbourne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Spencer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Chalmers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1984,9,8]]},"reference":[{"key":"ref_1","first-page":"220","volume":"284","author":"Episiotomy, Russell J.K.","year":"1982","unstructured":"Russell JK. Episiotomy. Br MedJ 1982;284:220.","journal-title":"Br MedJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1097\/00006254-198306000-00003","article-title":"Benefits and risks of episiotomy: an interpretative review of the English language literature, 1860-1980","volume":"38","author":"Thacker, S.E.; Banta, H.D.","year":"1983","unstructured":"Thacker SE, Banta HD. Benefits and risks of episiotomy: an interpretative review of the English language literature, 1860-1980. Obstet Gynecol Surv 1983;38: 322-38.","journal-title":"Obstet Gynecol Surv"},{"key":"ref_3","first-page":"817","article-title":"Practical obstetric problems","author":"Donald, I.","year":"1979","unstructured":"Donald I. Practical obstetric problems. London: Lloyd-Luke, 1979:817."},{"key":"ref_4","first-page":"51","article-title":"The real reasons for performing episiotomies","volume":"6","author":"Flood, C.","year":"1982","unstructured":"Flood C. The real reasons for performing episiotomies. World Medicine 1982 Feb 6:51.","journal-title":"World Medicine"},{"key":"ref_5","first-page":"6","article-title":"To do or not to do episiotomy","volume-title":"emotional aspects","author":"House, M.J.","year":"1981","unstructured":"House MJ. To do or not to do episiotomy. In: Kitzinger S, ed. Episiotomyphysical and emotional aspects. London: National Childbirth Trust, 1981:6-12."},{"key":"ref_6","article-title":"Some women's experiences of episiotomy","author":"Kitzinger, S.; Walters, R.","year":"1981","unstructured":"Kitzinger S, Walters R. Some women's experiences of episiotomy. London: National Childbirth Trust, 1981."},{"key":"ref_7","first-page":"400","article-title":"Episiotomy: has familiarity bred contempt ?","volume":"32","author":"Zander, L.","year":"1982","unstructured":"Zander L. Episiotomy: has familiarity bred contempt ? J R Coll Gen Pract 1982; 32:400-1.","journal-title":"J R Coll Gen Pract"},{"key":"ref_8","first-page":"480","article-title":"Evaluation of neonatal intensive care programs","volume":"305","author":"Sinclair, J.C.; Torrance, G.W.; Boyle, M.H.; Horwood, S.P.; Saigal, S.; Sackett, D.L.","year":"1981","unstructured":"Sinclair JC, Torrance GW, Boyle MH, Horwood SP, Saigal S, Sackett DL. Evaluation of neonatal intensive care programs. N EnglJ Med 1981;305:480-94.","journal-title":"N EnglJ Med"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1016\/S0140-6736(83)92412-1","article-title":"A randomized trial to evaluate the use of a birth chair for delivery","volume":"i:","author":"Stewart, P.; Hillan, E.; Calder, A.A.","year":"1983","unstructured":"Stewart P, Hillan E, Calder AA. A randomized trial to evaluate the use of a birth chair for delivery. Lancet 1983;i:1296-8. (Accepted 263June 1984)","journal-title":"Lancet"},{"key":"ref_10","article-title":"Supported partially by grant No 11-821, Langer Biomechanic Group Inc. Presented in part at the third international seminar on the treatment of rheumatic diseases, Israel","year":"1983","unstructured":"Supported partially by grant No 11-821, Langer Biomechanic Group Inc. Presented in part at the third international seminar on the treatment of rheumatic diseases, Israel, 13-20 November, 1983."},{"key":"ref_11","first-page":"599","article-title":"The sacroiliac joint. In Textbook of orthopaedic medicine","volume":"1","author":"Cyriax, J.","year":"1971","unstructured":"Cyriax J. The sacroiliac joint. In Textbook of orthopaedic medicine, 8th ed, Vol 1, 599-622, Baltimore: Williams and Wilkins, 1971.","edition":"8th ed"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1136\/bmj.1.6173.1285-d","article-title":"Sacroiliac strain","volume":"1","author":"Fitzgerald, R.T.D.","year":"1979","unstructured":"Fitzgerald RTD. Sacroiliac strain. Br MedJ 1979;1:1285-6.","journal-title":"Br MedJ"},{"key":"ref_13","first-page":"441","article-title":"of normal Clin Radiol subjects","volume":"32","year":"1981","unstructured":"of normal Clin Radiol subjects, 1981;32: 441-5."}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.289.6445.587","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.289.6445.587","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T22:26:25Z","timestamp":1765405585000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.289.6445.587"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,9,8]]},"references-count":13,"journal-issue":{"issue":"6445","published-online":{"date-parts":[[1984,9,8]]},"published-print":{"date-parts":[[1984,9,8]]}},"alternative-id":["10.1136\/bmj.289.6445.587"],"URL":"https:\/\/doi.org\/10.1136\/bmj.289.6445.587","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"value":"0007-1447","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1984,9,8]]}}}