“…Of note, 1 case-control retrospective study demonstrated decreased OR for shoulder dystocia with episiotomy use. 26 However, although this report noted numerous differences between shoulder dystocia and control group, including mean infant weight, maternal age, parity, and obesity rates, no adjustments were made in analyzing the results, and the researchers have noted that the lower proportion of episiotomy in shoulder dystocia cases can be explained by the significant higher proportion of multiparous patients in this group.…”