Data was collected about the mother, the infant and the pregnancy in women who had an episiotomy performed at delivery, and those who did not, in one district hospital and two community hospitals. Factors predisposing mothers to episiotomy were sought and compared in the different hospitals. Traditional indications for episiotomy, such as a large baby and a small mother, were found to be less important than the occurrence of fetal distress, prolongation of the second stage of labour and the presence of pupil midwives at delivery. Current practice in the use of episiotomy is discussed.