Episiotomy is an intentional surgical incision of the perineum after informed consent with the aim of increasing the soft tissue outlet dimensions to help with childbirth. It is not advocated for every delivery and the rate of episiotomy depends on the philosophy and judgment of the caregiver.Episiotomy is advocated when anterior tears with bleeding or multiple perineal tears appear. When there is fetal distress it is carried out to expedite delivery. It facilitates instrumental vaginal deliveries although the need for an episiotomy is less with ventouse deliveries and a distensible perineum. If the delivery process is delayed and it is thought to be due to a rigid perineum an episiotomy may facilitate delivery.