Episiotomy rates decreasing, but procedure still overused

May 07, 2002

LOS ANGELES, May 7 - While episiotomy rates have continued to decrease over the past 19 years, the procedure is still overused, according to researchers at the University of Pittsburgh School of Medicine.

"There has been a substantial drop - from 56 percent in 1979 to 31 percent in 1997 - but the rate is still too high," said Anne Weber, M.D., an associate professor of obstetrics, gynecology and reproductive sciences and an associate investigator at the Magee-Womens Research Institute. "Plus, this is a national average so it means that some hospitals, regions and individual doctors have rates that are even higher."

The finding is significant because women who undergo episiotomy - a deliberate incision into the perineum to enlarge the opening and ostensibly prevent tearing during birth -- have a higher risk of damage to underlying musculature, which can result in rectal dysfunction and fecal incontinence.

"Obviously, this is a horrible situation for a young mother to be in," said Dr. Weber, who presented the study at the 50th annual meeting of the American College of Obstetricians and Gynecologists. "These women also have a much higher risk of developing these problems in later years, even if they do not develop them right away."

Using data from the National Hospital Discharge Survey, Dr. Weber and her colleagues found that the number of episiotomies performed in the United States ranged from a high of 1.9 million in 1981 to a low of slightly less than 1.1 million in 1997, with an annual rate between 18 and 36 per 1,000 women ages 15 to 44. Rates were compared for vaginal and operative deliveries, with both rates declining over time.

Data analysis also revealed that women undergoing episiotomy were more likely to be younger, white and covered by private insurance than those who did not have the procedure.

For further review, similar data was used from the Magee-Womens Hospital of the UPMC Health System, a National Center of Excellence in Women's Health and a teaching hospital dedicated to the care of women and infants.

From 1995 to 1999, Dr. Weber and her colleagues found an overall episiotomy rate of 54 percent, according to the Magee-Womens Hospital Outcomes of Mothers and Infants database. Women who underwent episiotomy at Magee tended to be older, white and giving birth for the first time.

"Surprisingly, women undergoing operative vaginal delivery, say with forceps or vacuum, were less likely to receive episiotomy than those who spontaneously delivered," said Dr. Weber.

Magee residents and faculty had a very low percentage of episiotomy use (17.2 percent), compared to private practitioners (65.7 percent).

"What this analysis demonstrates is the persistence of high rates of episiotomy, particularly among private practitioners, despite current evidence-based recommendations to restrict use of the procedure," Dr. Weber said.
-end-
In addition to Dr. Weber, study authors include Leslie Meyn, M.S.; and Nancy Howden, M.D.

Magee-Womens Research Institute is the country's first research institute devoted to women and infants. It was formed in 1992 by Magee-Womens Hospital of the UPMC Health System. The University of Pittsburgh School of Medicine's department of obstetrics, gynecology and reproductive sciences is one of the top three departments in the nation in National Institutes of Health funding.

University of Pittsburgh Medical Center

Related Data Articles from Brightsurf:

Keep the data coming
A continuous data supply ensures data-intensive simulations can run at maximum speed.

Astronomers are bulging with data
For the first time, over 250 million stars in our galaxy's bulge have been surveyed in near-ultraviolet, optical, and near-infrared light, opening the door for astronomers to reexamine key questions about the Milky Way's formation and history.

Novel method for measuring spatial dependencies turns less data into more data
Researcher makes 'little data' act big through, the application of mathematical techniques normally used for time-series, to spatial processes.

Ups and downs in COVID-19 data may be caused by data reporting practices
As data accumulates on COVID-19 cases and deaths, researchers have observed patterns of peaks and valleys that repeat on a near-weekly basis.

Data centers use less energy than you think
Using the most detailed model to date of global data center energy use, researchers found that massive efficiency gains by data centers have kept energy use roughly flat over the past decade.

Storing data in music
Researchers at ETH Zurich have developed a technique for embedding data in music and transmitting it to a smartphone.

Life data economics: calling for new models to assess the value of human data
After the collapse of the blockchain bubble a number of research organisations are developing platforms to enable individual ownership of life data and establish the data valuation and pricing models.

Geoscience data group urges all scientific disciplines to make data open and accessible
Institutions, science funders, data repositories, publishers, researchers and scientific societies from all scientific disciplines must work together to ensure all scientific data are easy to find, access and use, according to a new commentary in Nature by members of the Enabling FAIR Data Steering Committee.

Democratizing data science
MIT researchers are hoping to advance the democratization of data science with a new tool for nonstatisticians that automatically generates models for analyzing raw data.

Getting the most out of atmospheric data analysis
An international team including researchers from Kanazawa University used a new approach to analyze an atmospheric data set spanning 18 years for the investigation of new-particle formation.

Read More: Data News and Data Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.