Since the only undisputed reason for doing episiotomies is severe fetal distress at the point of giving birth, the episiotomy rate for hospital-based practitioners shouldn't be much greater. Therefore, 10 percent or so would be a reasonable episiotomy rate.
1. ACOG. Operative vaginal delivery. Technical Bulletin No. 196, 1994.
2. Argentine Episiotomy Trial Collaborative Group. Routine vs selective episiotomy: a randomised controlled trial. Lancet 1993;342:1517-1518.
3. Carroli G and Belizan J. Episiotomy for vaginal birth. In: The Cochrane Library, 1999. Oxford: Update Software.
4. Combs CA, Murphy EL, and Laros RK. Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol 1991;77(1):69-76.
5. Cunningham FG et al., eds. William's Obstetrics. 20th ed. Stamford, CT: Appleton and Lange, 1997.
6. Eason E et al. Preventing perineal trauma during childbirth: a systematic review. Obstet Gynecol 2000;95(3):464-71.
7. Ecker JL. Is there a benefit to episiotomy at operative vaginal delivery? Observations over ten years in a stable population. Am J Obstet Gynecol 1997;176:411-4.
8. Graham ID. Episiotomy: Challenging Obstetric Interventions. Oxford: Blackwell Science Ltd., 1997.
9. Haadem K et al. Anal sphincter function after delivery rupture. Obstet Gynecol 1987;70(1):53-56.
10. Helwig JT, Thorp JM, and Bowes WA. Does midline episiotomy increase the risk of third- and fourth-degree lacerations in operative vaginal deliveries? Obstet Gynecol 1993:82(2):276-9.