While few modern obstetricians are willing to go as far as DeLee, these beliefs about women still pervade obstetrics, and they fuel episotomy. Episiotomy serves another purpose. Davis-Floyd observes that surgery holds the highest value in the hierarchy of Western medicine, and obstetrics is a surgical specialty. In short, routine episiotomy has a ritual function but serves no medical purpose. If any reader believes otherwise, I challenge him or her to find a credible study done in the past 15 years that supports those beliefs.
Mediolateral episiotomies are the opposite.
Because of these differences, I will note which type was performed after the abstract citation. Because of these differences, I have excluded studies of mediolateral episiotomy where data were available on median episiotomies. For many areas of interest, however, they were unavailable. This is because until very recently, U.S. and Canadian doctors were so convinced of episiotomy's value that they did not feel it necessary to test their theory. This was less true of European midwives, and by extension, the doctors with whom they work.