Weird small lump in perineum a month after episiotomy. should i call ob?

Always reasonable: There are several reasons this may occur. Scar tissue, an inclusion cyst, or suture granuloma may have occured. There may be hypertrophic scarring or less commonly a keloid forming. Certianly to evaulate for infection is a good reason to visit the ob/gyn. He or she can usually rapidly determine if anything further needs to be done.

Yes: Could have developed a cyst or suture granuloma that isnt dissolving on its own. Needs to be checked out.