Big Cut to Childbirth Surgery Rate

Episiotomy rate declined significantly over past decade

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Giving birth is hard enough, so why add a surgery to the mix? A surgery once common during childbirth may be going extinct for routine births.

Rates of episiotomy, in which the birth canal is surgically widened to ease the childbirth process, are declining, Alexander M. Friedman, MD, of the Columbia University College of Physicians and Surgeons in New York City, and colleagues found in a recent study.

Dr. Friedman and colleagues studied patient data from over 500 hospitals and concluded that the rate of episiotomies has been cut almost in half over the past decade.

The authors of this study noted that the findings are in line with recommendations from the American Congress of Obstetricians and Gynecologists in 2006, which said that the procedure should not be routine.

The reason? "Episiotomies, like other surgical interventions, are not without risk or complication," said Andre F. Hall, MD, of Birth and Women's Care in Fayetteville, NC, in an interview with dailyRx News. "Bleeding, infection and ongoing pain at the episiotomy site are some of the potential issues that can occur after an episiotomy is performed."

Only 10 years ago, obstetricians used episiotomy during 1 in 4 births, Dr. Friedman and team noted.

Researchers looked at data from more than 2 million births to determine how rates of episiotomy have changed between 2006 and 2012. During this time, more than 325,000 women, or 14.4 percent of the study population, underwent episiotomy.

In 2006, 17.3 percent of patients underwent the procedure. By 2012, that number had dropped to 11.6 percent.

"Our findings demonstrate that use of episiotomy declined over time, possibly reflecting adoption of recommendations," Dr. Friedman and colleagues wrote.

This study was published Jan. 13 in JAMA.

The authors did not disclose any funding sources or conflicts of interest.

Review Date: 
January 12, 2015
Last Updated:
January 16, 2015