"...Dr. JM Thorp, in Episiotomy: Can its routine use be defended?, says, "There is little evidence to support routine use of episiotomy. This procedure may well increase the incidence of third- and fourth-degree lacerations. There are few data to support the premise that this procedure prevents pelvic relaxation."
The American College of Obstetricians and Gynecologists say that episiotomy "is not always necessary" and "should not be considered routine." However, estimates claim that the episiotomy rate in the United States is 65-95%, depending on the parity (number of babies previous born).
Episiotomies are said to provide the following benefits:
Speed up the birth
Protects against incontinence
Protects against pelvic floor relaxation
Heals easier than tears
These all appear to be valid reasons. The fact is, that medical research has not proven any of these benefits. In fact, in many of the cases, the opposite is actually true. Episiotomies can actually cause harm.
The following have been reported as side effects of the episiotomy:
Increase in 3rd and 4th degree vaginal lacerations (euphemistically called extensions)
Longer healing times
Increased discomfort when intercourse is resumed
Midwife MH Bromberg says it best with, "Review of the literature on episiotomy indicates the likelihood that it is over used, with shaky justification at best. It seems reasonable to infer that a median episiotomy has no great advantage over a first- (into the skin) or second-degree (into the underlying muscle) laceration when there are no overriding fetal indications..."
Episiotomy - Is it really necessary?