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Fewer Episiotomies, but Nonmedical Factors May Persist

Almost 12 percent of deliveries still involve the surgical procedure

TUESDAY, Jan. 13, 2015 (HealthDay News) -- The incidence of episiotomy has been declining since the 1990s because of concerns regarding related risks and benefits, researchers report in the Jan. 13 issue of the Journal of the American Medical Association.

To assess current rates, study author Alexander Friedman, M.D., and his colleagues at the Columbia University College of Physicians and Surgeons in New York City, examined data on 2,261,070 American women who had vaginal deliveries at 510 different facilities between 2006 and 2012. Overall, 14.4 percent underwent an episiotomy during that period.

In 2006, 17.3 percent of deliveries involved the surgery, compared to 11.4 percent in 2012. But some hospitals perform significantly more episiotomies than others, the researchers said. Among the 10 percent of hospitals that most often performed the surgery, episiotomies were performed among 34.1 percent of births. 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 to have the procedure. "These observations suggest nonmedical factors are related to use of episiotomy," the authors write.

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