ABSTRACT
Some people claim that the operation should be used liberally on the grounds that this will reduce both serious vaginal and perineal tears as well as longer term problems such as stress incontinence and vaginal prolapse.3, 4 Others maintain that episiotomy should be largely restricted to fetal indications because they believe that perineal tears cause women fewer problems than episiotomies done to prevent them.5-7
These differing views are reflected in the widely varying use of the operation; a recent survey of British maternity units reported hospital rates ranging from 14% to 96% in primiparas and from 16% to 71% in multiparas (M. J. House, personal communication). In particular, this variation is an expression of differing opinions about the use of the operation for maternal indications in non-instrumental delivery.
