Altough there is little clinical evidence suggesting that episiotomies should be carried out routinely, over 200,000 of these operations are performed every year in the UK and over 1.5 million in the US. This book focuses on the process of innovation and change in the use of this controversial procedure by tracing the evolution of its liberal or routine use in the UK and the US. It discusses the influence of professional and institutional pressure on bringing about change, and highlights the importance of the recent backlash by midwives and women"s groups to greatly reduce the use of this procedure. Episiotomy: Challenging Obstetric Interventions is an essential text for all those involved in effecting change within midwifery practice and management.