title: Episiotomy is still performed routinely in Yemeni women.
abstract: OBJECTIVE
  To examine the rate of episiotomy use among nulliparous Yemeni women, and to evaluate its impact on perineal tears.
  
  
  METHODS
  We retrospectively reviewed the delivery record for all nulliparous women with and without episiotomy and singleton spontaneous births at Al-Thawra General Hospital, Sana'a, Yemen between January and December 2008. The womens' charts were retrieved, and the demographic characteristics were obtained. For women with episiotomy, the indication and type of incision were noted. The rate of the procedure and the perineal tears was recorded, and compared between women with and without episiotomy.
  
  
  RESULTS
  A total of 2588 nulliparous women had singleton spontaneous births. Out of these, 1944 (75.1%) women had an episiotomy. Most cases (96%) had a mediolateral incision. Seventeen episiotomy cases (0.87%) were complicated by second and third degree perineal tears versus 12 cases (1.7%) with the same type of tear in women without the procedure.
  
  
  CONCLUSIONS
  Episiotomy is still performed routinely in 75.1% of first-time births. This rate is higher than supported by the available evidence.
authors.affiliation: Obstetrics and Gynecology Department, Faculty of Medicine, Thamar University, Sana'a, Yemen.
authors.forename: Kaima A
authors.initials: KA
authors.lastname: Frass
authors.forename: Abdelrahman H
authors.initials: AH
authors.lastname: Al-Harazi
mesh_terms: D000328:Adult; D004841:Episiotomy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015006:Yemen