Introduction: Episiotomy and perineal lacerations are common perineal traumas during the primiparous vaginal birth and is the most common operation in obstetrics. There is no reliable evidence for routine use of episiotomy and it is recommended to perform selective episiotomy for fetal maternal indications. There for this study was performed by the objective, comparison of perineal traumas level in primiparous women with routine and selective episiotomy.
 
Materials and Methods: This randomized clinical trial was carried out in 2003 on 100 primiparous women, between 17-35 years old with spontaneous delivery, at Modarres hospital in Kashmar. Sampling accomplished by purposeful method. They randomly allocated in two groups with routine and selective episiotomy. Delivery of subjects done by the researcher, but evaluation of perineal outcome, after delivery completed by the assistant researcher, who did not know about the group of samples. Trial allocation data obtained by interviewing, observation forms, measurement of pelvic muscle strength and were analyzed with t-test, chi-square, Mann Whitney and Fisher test, using SPSS software.
 
Results: Of100 women studied, 12(24%) in selective group and 50(100%) in routine group had episiotomy (p<0/0001). Perineal traumas in selective, routine groups were 62% and 100% respectively. These findings varied statistically (p<0/0001). In this study, two groups did not differ statistically regarding the effectiveness of variables on perineal traumas.
 
Conclusion: Selective episiotomy can reduce the perineal traumas Level, thus as a safe method, should replace the routine episiotomy.