Episiotomy

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). This indicator examines the frequency of episiotomy for women having their first baby and giving birth vaginally, either with or without the assistance of instruments. For more information, see Clinical commentary.

Key findings

  • The proportion of women having their first baby vaginally with an episiotomy has increased over time for both assisted (instrumental) and unassisted births, although it remains consistently lower for unassisted births (24% in 2020) compared to assisted (82%).
  • Episiotomies during unassisted births were least common for women younger than 20 and most common for women in their 30s, between 2004 and 2020.

The interactive data visualisation below presents data on episiotomy for women having their first baby and giving birth vaginally assisted, by selected maternal characteristics. Click the Data tables button to view the data between 2004 and 2020 and use the radio buttons to see how each characteristic has changed during this time.

Episiotomy for women having their first baby and giving birth vaginally (instrumental), by State/territory of birth and all Australia, 2004 to 2020.

This chart shows the proportion of women having their first baby with an episiotomy and giving birth vaginally assisted (with instruments), by state/territory of birth, 2004 to 2020.  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 61% in 2004 to 82% in 2020.

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% in 2004 to 24% in 2020.

Clinical commentary

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 possible use of episiotomy during a vaginal birth must be discussed prospectively with the woman (ACSQHC 2021).

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).

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.