While episiotomies are no longer routinely performed in usual obstetric care, we wanted to include this older video because the repair is the same as one would use for repair of a second degree vaginal laceration.

Episiotomies are no longer routinely recommended. Data show they are associated with a higher rate of 3rd and 4th degree perineal lacerations than when a patient is allowed to tear naturally. They are not an effective strategy for protecting the maternal pelvic floor.

There are still occasional clinical circumstances where an episiotomy is indicated, such as in management of some shoulder dystocias.

 – Dr. Smith and Dr. Hughey