Abstract: Background & context. Postpartum perineal pain is one of the most common morbidities after vaginal birth. In India—where ~89% of births are now institutional (and ~87% even in rural areas)—perineal trauma from episiotomy or spontaneous tears affects large numbers of new mothers, with consequences for mobility, breastfeeding, continence, sexual health, and mental wellbeing. Global guidance discourages routine episiotomy and emphasizes correct repair, yet studies from Indian settings continue to report high and variable episiotomy rates and gaps in repair technique, supplies, and training, especially in rural facilities.