How did episiotomy rates change from 2007 to 2014? Population-based study in France

Abstract Background Since the 2000s, selective episiotomy has been systematically recommended worldwide. In France, the recommended episiotomy rate in vaginal deliveries is less than 30%. The aims of this study were to describe the evolution of episiotomy rates between 2007 and 2014, especially for vaginal deliveries without instrumental assistance and to assess individual characteristics and birth environment factors associated with episiotomy. Methods This population-based study included all hospital discharge abstracts for all deliveries in France from 2007 to 2014. The use of episiotomy in vaginal deliveries was identified by one code in the French Common Classification of Medical Procedures. The episiotomy rate per department and its evolution is described from 2007 to 2014. A mixed model was used to assess associations with episiotomy for non-operative vaginal deliveries and the risk factors related to the women’s characteristics and the birth environment. Results There were approximately 540,000 non-operative vaginal deliveries per year, in the study period. The national episiotomy rate for vaginal deliveries overall significantly decreased from 26.7% in 2007 to 19.9% in 2014. For non-operative deliveries, this rate fell from 21.1% to 14.1%. For the latter, the use of episiotomy was significantly associated with breech vaginal delivery (aOR = 1.27 [1.23–1.30]), epidural analgesia (aOR = 1.45 [1.43–1.47]), non-reassuring fetal heart rate (aOR = 1.47 [1.47–1.49]), and giving birth for the first time (aOR = 3.85 [3.84–4.00]). Conclusions The episiotomy rate decreased throughout France, for vaginal deliveries overall and for non-operative vaginal deliveries. This decrease is probably due to proactive changes in practices to restrict the number of episiotomies, which should be performed only if beneficial to the mother and the infant.

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PID https://www.doi.org/10.6084/m9.figshare.c.4122965
PID https://www.doi.org/10.6084/m9.figshare.c.4122965.v1
URL https://dx.doi.org/10.6084/M9.FIGSHARE.C.4122965
URL https://dx.doi.org/10.6084/m9.figshare.c.4122965.v1
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Author Goueslard, Karine
Author Cottenet, Jonathan
Author Roussot, Adrien
Author Clesse, Christophe
Author Sagot, Paul
Author Quantin, Catherine, 0000-0001-5134-9411
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Collected From Datacite
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Publication Date 2018-06-05
Publisher figshare Academic Research System
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Source https://science-innovation-policy.openaire.eu/search/dataset?datasetId=dedup_wf_001::e1a4f60573a9527ab3658f0f0539bbb8
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Last Updated 14 January 2021, 13:40 (CET)
Created 14 January 2021, 13:40 (CET)