Decades of clinical research has discovered that
episiotomy had few documented benefits. One study6 has
suggested an optimal episiotomy rate for vaginal
deliveries of less than 5% and an operative vaginal
delivery rate of less than 6%.6 The 2006 American
Congress of Obstetricians and Gynaecologists (ACOG)
Practice Bulletin recommends that obstetricians should
restrict their use of episiotomy.7 The largest two
randomized controlled trials (RCTs) of episiotomy suggest
that women who undergo episiotomy are at increased
risk for third- and fourth-degree tears