Episiotomy

Chart title: Episiotomy for women having their first baby and giving birth vaginally assisted (instrumental), by State/territory of birth and all Australia, 2004 to 2019.

This chart shows the proportion of women having their first baby with an episiotomy and giving birth vaginally (instrumental), by state/territory of birth, 2004 to 2019.  Data can be viewed for each state/territory of birth, and for all Australia. The proportion of women giving birth for the first time, vaginally assisted (with instruments) who had an episiotomy increased from 60.7% in 2004 to 79.6% in 2019.

The chart also includes an option to view data for the proportion of women giving birth for the first time, vaginally without the use of instruments who had an episiotomy. This has increased from 16.2% in 2004 to 23.2% in 2019.

Clinical Commentary

An episiotomy is an incision made in the perineum (the tissue between the vaginal opening and the anus) and vagina to enlarge the vaginal opening (RCOG 2015). Episiotomy can shorten the second stage of labour, but the consequences of the trauma to the perineum and, potentially to the anus and rectum, need to be balanced against the need for episiotomy. The use of episiotomy must be discussed prospectively with the woman (RCOG 2015).

Evidence suggests that selective use of episiotomy is better practice than routine use of episiotomy and may reduce the level of pain, urinary incontinence, painful sex or severe perineal trauma (Jiang et al. 2017; RCOG 2015).

Indicator specifications and data

Excel source data tables are available from the Data tab.

For more information refer to Specifications and notes for analysis in the technical notes.

References

Jiang H, Qian X, Carroli G & Garner P 2017. Selected versus routine use of episiotomy for vaginal birth. Cochrane Database of Systematic Reviews 2: CD000081.

RCOG (The Royal College of Obstetricians and Gynaecologists) 2015. The management of Third- and Fourth-degree Perineal Tears: Green top guideline no. 29 (PDF). Viewed 6 October 2021.