Analized was a five year period of the delivery room at the General Hospital of Karlovac. Research was done to compare the analysis of episiotomy procedures from the years 2007 and 2017. The data obtained shows a significant difference and a great deal of change in birthing. The changes are the results not only in the advancement of the profession but also a change in the thinking of our patients. There is a large influence of foreign literature, education and the change in attitude twards birth. When analyzing the historical examination, where it has gone from a routine and unquestionable procedure to the procedure we use today by indication. Its path has gone from strict specialist intervention to a procedure now lead by midwives. From studying many papers on the topic of episiotomy it is safe to conclude that obstetricians now leave decision making and procedure to the midwives. She is the one who follows the perineum, its elasticity and how the head protrudes. The midwives are not only active at birth but also have contact with the patients during birthing classes. Their doors are always open to all questions. In the year 2007, 90% of episiotomy procedures were done to those having their first born. In the last two years the amount of episiotomy procedures has fallen to 21% in vaginal births. In closure, the maternity ward at the General Hospital of Karlovac is at an enviable level when comparing the recommendation of 10-20% from the World Health Organization on the amount of episiotomy procedures in primary and secondary maternity wards.