Episiotomy: A Twentieth Century Procedure?

Recent estimates suggest that episiotomy is performed in 60% of deliveries in the U.S., making it one of the most common surgical procedures performed. Once taught as essential to protect the perineum and to shorten the second stage of labor, the episiotomy has more recently been attacked as an unnecessary surgical procedure leading to pain and disfigurement without substantiated benefit. Many clinicians have altered their practice patterns to perform episiotomy "only if needed" rather than "prophylactically," and some women are presenting for prenatal care requesting or insisting that no episiotomy be performed at delivery.

Episiotomy came into common practice in the U.S. in the 1920s. Its rapid rise in popularity was primarily due to the e…