Methods	Generation method of randomization not established. Concealment method of allocation by envelopes.
Participants	Number of participants not established. There is only information for 165 women available to follow up but it lacks information about those women lost to follow up either because one of the authors was not available, or because of the early discharge scheme. Women were at least 37 weeks’ gestational age, cephalic presentation and vaginal delivery
Interventions	In one group episiotomy was not performed specifically to prevent laceration Another group were to receive standard current management whereby perineal damage was avoided by control of the descent of the head and supporting the perineum at crowning. An episiotomy was made if there was fetal distress, or for maternal reasons to shorten the 2nd stage such as severe exhaustion, inability to complete expulsion or unwillingness to continue pushing. Episiotomy was performed if the perineum appeared to be too tight or rigid to permit delivery without laceration, or if a laceration appeared imminent
Outcomes	Second degree tear. Third degree tear. Need for perineal suturing. Any perineal pain at 3 days. Healing at 3 days. Tenderness at 3 days. Perineal infection at 3 days. Blood loss during delivery
Notes	Mediolateral episiotomies. Epsiotomy rate for restricted group were 18% and for the routine group were 69%
Risk of bias
Bias	Authors’ judgement	Support for judgement
Allocation concealment (selection bias)	Low risk	A - Adequate