Episiotomy: Can its routine use be defended?

A careful review finds little evidence to support the argument that episiotomy reduces perineal trauma and prevents subsequent pelvic relaxation, and may predispose the gravid woman to third- and fourth-degree lacerations.

Abstract

Episiotomy is routinely used before delivery in the United States. The rationale for routine episiotomy is based on two foundation arguments: that episiotomy reduces perineal trauma and that it prevents subsequent pelvic relaxation. A careful review finds little evidence to support these arguments. Episiotomy may predispose the gravid woman to third- and fourth-degree lacerations. Efforts should be directed to determine whether episiotomy is beneficial.