Response to the letter to the editor: the correct episiotomy—does it exist?

Excerpt

The concept of episiotomy was introduced in 1741. This procedure is still sparingly used in many countries, despite the surprising lack of evidence to support its benefits. According to several recent systematic reviews and meta-analyses, no solid evidence has been demonstrated in the professional literature to recommend episiotomy performance even in the most “classic” scenarios, such as prevention and management of shoulder dystocia, vacuum delivery, and prevention of impending tear [1‐3]. Furthermore, this procedure may be related to an increased risk of various obstetric complications, such as postpartum bleeding, pain, and a higher rate of advanced perineal lacerations [3]. Thus, in our opinion, episiotomy should be maximally restricted unless large randomized controlled trials are published supporting its use. …