Episiotomies on the Decline for U.S. Births

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An operation called an episiotomy, which widens the birth canal to facilitate easier deliveries, seems to be on the decline in the United States, a new study indicates.

As recently as a decade ago, an episiotomy was performed during roughly one-quarter of all vaginal births. But overall incidence has been declining since the 1990s because of concerns regarding related risks and benefits, the researchers said.

To assess current rates, study author Dr. Alexander Friedman and his colleagues at the Columbia University College of Physicians and Surgeons in New York City examined data on more than 2.2 million American women who had vaginal deliveries at 510 different facilities between 2006 and 2012.

Overall, a little more than 14 percent underwent an episiotomy during that period, the researchers report in the Jan. 13 issue of JAMA.

In 2006, about 17 percent of deliveries involved the surgery, compared to less than 12 percent in 2012, the study found.

But some hospitals perform significantly more episiotomies than others, the researchers said.

“These observations suggest nonmedical factors are related to use of episiotomy,” the authors said in a journal news release.

Among the 10 percent of hospitals that most often performed the surgery, episiotomies were performed among more than 34 percent of births, they said. But in the 10 percent of hospitals where it was least popular, the procedure was applied in 2.5 percent of births.

White women were almost twice as likely as black women to undergo an episiotomy, the data indicated. And women with private insurance were more likely than those with Medicaid — the publicly funded insurance program for the poor — to have the procedure.

More information

For more on episiotomies, visit the U.S. National Institutes of Health.

Source: HealthDay

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