A recent cohort study reported a significant reduction in the prevalence of episiotomy in France since the adoption of restrictive guidelines in 2005, with decreased rates observed across all obstetric classification groups. The study highlighted successful reduction in episiotomy prevalence without a corresponding increase in obstetric anal sphincter injuries (OASI) for the general population. However, concerns were raised about increased OASI risk in certain instrumental delivery contexts, prompting a recommendation for further research to predict the optimal rate of episiotomy for instrumental deliveries.