Perineal injuries, whether resulting from natural lacerations or the practice of episiotomy, represent a common complication that can have a substantial effect on the well-being of postpartum women. The present study utilized the Fuzzy Cognitive Mapping methodology to analyze the interrelationship between risk factors associated with episiotomies and postpartum complications. These factors, individually or in combination, can significantly increase the risk of post-episiotomy infectious complications. This approach will enable a comprehensive understanding of the problem, with the aim of developing more effective strategies to reduce the incidence of complications and improve care for postpartum women. The systematic literature review identified several associated risk factors and complications. The retrospective observational study examined 20 medical records of postpartum women who underwent episiotomy at the Santa Inés Ambato Hospital between 2020 and 2023. The structured survey was applied to 50 professionals with experience in obstetric care from 3 healthcare institutions, while the semi-structured interviews were conducted with 20 postpartum women who underwent episiotomy in the last 6 months at the same hospital. The results provided a deep understanding of the risk factors and complications associated with episiotomy. The impact on the quality of life of women who underwent episiotomy is significant, affecting their physical and emotional well-being. Personalized care protocols based on the identified risk factors are proposed, with the aim of reducing the incidence of complications.