Methods	Random generation: not stated. Allocation concealment: sealed opaque envelopes.
Participants	146 primiparous women. Gestation of > 34 weeks, with an uncomplicated pregnancy and a live singleton fetus. Women were intending to have a vaginal delivery
Interventions	Restrictive: try to avoid an episiotomy even if severe perineal trauma was judged to be imminent and only do it for fetal indications. Liberal: in addition to fetal indications use of episiotomy when a tear is judged to be imminent
Outcomes	Reduction of episiotomies, increase of intact perinea and only minor perineal trauma, perineal pain in the postpartum period, percentage change in overall anterior perineal trauma, difference of the PH of the umbilical artery, percentage of umbilical artery PH less than 7.15, percentage of Apgar scores less than 7 at 1 minute, maternal blood loss at delivery, percentage of severe perineal trauma
Notes	Mediolateral episiotomies. Epsiotomy rates were 70% for restricted group and 79% for the routine group
Risk of bias
Bias	Authors’ judgement	Support for judgement
Allocation concealment (selection bias)	Low risk	A - Adequate