An episiotomy may be necessary in several situations, including: - Fetal distress: To expedite delivery when the baby shows signs of distress. - Instrumental delivery: When forceps or a vacuum extractor is used. - Breech delivery: When the baby is delivered feet or buttocks first. - Shoulder dystocia: When the baby's shoulder gets stuck after the head has been delivered. - Large baby: When the baby is particularly large, posing a risk for severe tearing.
