The Need to Avoid the Routine Use of Episiotomy

The justification of the routine use of the episiotomy arose at the beginning of 20th century. It was based on personal beliefs without scientific basis that endorsed this recommendation. This led to the incorporation of episiotomy in daily practice being a routine procedure, especially in nulliparous women. Since 1985 many researches of good experimental design were generated to verify if routine episiotomy was justified. High-quality methodological studies gave strong evidence that the episiotomy should not be done routinely in view of the fact that it does give benefits neither for the women nor for the newborns. Its use should be restricted to certain clinical situations. However, the episiotomy continues to be a customary practice even though the available evidence for more than one decade ago shows that it does not improve maternal or perinatal health. This suggests that there is a need for implementing interventions to change practitioner's behaviour.