Moshe-Mordechai van Zuiden
Psychology, Medicine, Science, Politics, Oppression, Integrity, Philosophy, Jews

Mothers who have episiotomy in first delivery more likely to need one in next?

This is the text of a nonsensical piece of medical news about a surgical cut sometimes given during delivery.

Statistics are fun things. You can prove anything with them – to people who don’t pay attention. The mistake here is so basic and simple that one wonders what happened to down-to-earth common sense here.

The article opens with this statement: “Mothers who have an episiotomy during their first delivery are more likely to require the procedure in subsequent deliveries, according to researchers from Ben-Gurion University of the Negev and Soroka University Medical Center in Beersheba,” which should mean that two groups were compared and one scored higher.

In statistics, choosing an appropriate control group to compare your findings is crucial. It’s also the hardest thing to do. Say, you find a certain illness increased in a certain population. Then you want to know if that population changed or if the percentage of sick people changed. That is not so simple. Maybe they started eating differently, maybe there is more illness because fewer people died and it’s a sickness that comes with age. There are a million pitfalls to think of before drawing any conclusion. But our case here is not complicated at all (so wrong it is).

Of the women who needed a surgical cut during their delivery, 17.5 of those who needed that during their first delivery need one again during their second one. They claim that that is worrisome because the average for women who had none but needed one during the second time is only 3.1. The WHO recommends that it won’t exceed 10% (not as reported that it will be 10%).

Now the real story.

There is a small number of women that need such a cut at their first delivery. Of this 100% that needed it at their next delivery, 82.5% of them don’t need that again the next delivery. Their need falls from 100% to 17.5% Great progress.

Of course, you cannot compare this 17.5% to the local average to or general international norms because those are not compatible groups. Think of a Yemenite mother and a Dutch father. Great chance the child will be a bit big for the mother to birth.

If at the next delivery, only 17.5% needs another cut, that is almost 6 times better than the first time. That is not worrisome for the same couple at all. (Not a word if they checked that it was the same couple. They only discuss the mothers. A serious oversight.)

So the headline should proclaim good news. Mothers who have episiotomy in first delivery six times less likely to need one in next.

About the Author
The author is a fetal survivor of the pharmaceutical industry (DES - Diethylstilbestrol), born in 1953 to two Dutch Holocaust survivors who met in the largest concentration camp in the Netherlands, Westerbork, and holds a BA in medicine (University of Amsterdam). He taught Re-evaluation Co-counseling, became a social activist, became religious, made Aliyah, and raised three wonderful kids. He wrote an unpublished tome about Jewish Free Will. He's a vegan for 8 years now. * His most influential teachers (chronologically) are: his parents, Nico (natan) van Zuiden and Betty (beisye) Nieweg, Wim Kan, Mozart, Harvey Jackins, Marshal Rosenberg, Reb Shlomo Carlebach and lehavdiel bein chayim lechayim: Rabbi Dr. Natan Lopes Cardozo and Rav Zev Leff. * Previously, for decades, he was known to the Jerusalem Post readers as a frequent letter writer. For a couple of years he wrote hasbara for the Dutch public. His fields of attention now are varied: Psychology (including Sexuality and Abuse), Medicine (including physical immortality), Science, Politics (Israel, the US and the Netherlands, Activism - more than leftwing or rightwing, he hopes to highlight Truth), Oppression and Liberation (intersectionally, for young people, the elderly, non-Whites, women, workers, Jews, GLBTQAI, foreigners and anyone else who's dehumanized or exploited), Integrity, Philosophy, Jews (Judaism, Zionism, Holocaust and Jewish Liberation), Ecology and Veganism. Many people can't understand or like him because he has such a wide vision that he never fits any specialist's box. But that exactly what others love about him. Many of his posts relate to affairs from the news or the Torah Portion of the Week or are new insights that suddenly befell him. * He hopes that his words will inspire and inform, reassure the doubters but make the self-assured doubt more. He strives to bring a fresh perspective rather than bore you with the obvious. He doesn't expect his readers to agree. Rather, original minds must be disputed. In short, his main political positions are: anti-Trumpism, for Zionism, Intersectionality, non-violence, democracy, anti the fake peace process, for original-Orthodoxy, Science, Free Will, anti blaming-the-victim and for down-to-earth optimism. Read his blog how he attempts to bridge any discrepancies. He admits sometimes exaggerating to make a point, which could have him come across as nasty, while in actuality, he's quit a lovely person to interact with. He holds - how Dutch - that a strong opinion doesn't imply intolerance of other views. * His writing has been made possible by an allowance for second generation Holocaust survivors from the Netherlands. It has been his dream since he was 38 to try to make a difference by teaching through writing. He had three times 9-out-of-10 for Dutch at his high school finals but is spending his days communicating in English and Hebrew - how ironic. G-d must have a fine sense of humor. In case you wonder - yes, he is a bit dyslectic. November 13, 2018, he published his 500st blog post with the ToI. * He likes doing age-appropriate and age-inappropriate things and looks forward to getting to know his timeless mature out-of-the-box soul mate. * To send any personal reaction to him, scroll to the top of the blog post and click Contact Me.
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