The routine use of episiotomy was popularized in 1940s and 1950s; with the widely accepted justification for liberal use especially in nulliparous women being that it facilitates delivery, prevents perineal lacerations, spares the baby’s head from trauma, and avoids undue stretching of pelvic floor, which could predispose to subsequent uterovaginal prolapse. The rates of episiotomy from eleven developing countries including India showed that episiotomy rates for nullipara were higher than 90% in all countries (mean 93%, range 91-100%). In India the overall episiotomy rate for women delivering in tertiary level public hospitals is about 70%. The present clinical randomized trial was performed to compare maternal and perinatal outcomes in women submitted to a restrictive episiotomy vs. liberal usage of episiotomy.
