OBSintermediate
State the five essential procedural steps and precautions required to safely perform an episiotomy regarding clinical indication, pain relief, timing, fetal safety, and incision execution.
Answer
1. Confirm a valid clinical indication. 2. Administer adequate analgesia or anaesthesia (commonly lignocaine infiltration along the incision line). 3. Wait until the fetal head has crowned. 4. Protect the fetal head (inserting fingers between the head and perineum). 5. Make a single, clean incision.
Explanation
The slides emphasize that episiotomy should have a valid indication and be performed only when the head has crowned. Analgesia or anaesthesia is required, commonly lignocaine infiltration along the incision line. The fetal head should be protected and the incision made cleanly. These steps reduce avoidable procedural harm and support safe care.\n\n**Key takeaway:** Indication, analgesia, crowning, fetal-head protection, and a clean incision are central procedural points.\n\n**Glossary:** **Crowning**: The stage when the fetal head remains visible at the vaginal opening; **lignocaine**: A local anaesthetic.
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