Which of the following clinical scenarios is an accepted indication for performing an episiotomy?

The material lists a perineum threatening to tear badly, particularly a rigid perineum; the need for room for manoeuvres associated with breech birth, shoulder dystocia, or delivery of a second twin; and forceps delivery. It does not identify routine prevention of all haemorrhage or every uncomplicated birth as indications.\n\n**Key takeaway:** Base episiotomy on a specific clinical indication, not routine use.\n\n**Glossary:** **Rigid perineum**: Perineal tissue that is relatively inelastic; **obstetric manoeuvre**: A clinical technique used to assist delivery.