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U.S. trends in obstetric procedures, 1990-2000.

Lola Jean Kozak1, Julie Dawson Weeks

  • 1Hospital Care Statistics Branch, Division of Health Care Statistics, National Center for Health Statistics, Hyattsville, Maryland 20782, USA.

Birth (Berkeley, Calif.)
|August 3, 2002
PubMed
Summary

Obstetric procedure rates remained stable in the 1990s, unlike the 1980s. However, the types of procedures, including labor induction and vacuum extraction, continued to shift during this decade.

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Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Health Services Research

Background:

  • The 1980s saw a significant rise in obstetric procedures during delivery.
  • This study examines obstetric procedure trends throughout the 1990s to identify continuations or changes from the previous decade's patterns.

Purpose of the Study:

  • To analyze trends in the utilization of obstetric procedures during the 1990s.
  • To compare the patterns of obstetric procedure use in the 1990s with those observed in the 1980s.

Main Methods:

  • Utilized data from the National Hospital Discharge Survey, a nationally representative dataset.
  • Included approximately 32,000 annual records of women with deliveries.
  • Examined total obstetric procedures and eight specific interventions: cesarean section, labor induction (medical/surgical), artificial rupture of membranes, episiotomy, repair of obstetric laceration, vacuum extraction, and forceps delivery.

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Main Results:

  • The overall rate of obstetric procedures showed no significant change between 1990 and 2000.
  • Rates for labor induction, vacuum extraction, and repair of obstetric laceration increased, mirroring 1980s trends.
  • Rates for forceps delivery and episiotomy decreased, also consistent with 1980s trends.
  • Cesarean section rates declined from 1988 to 1995 before increasing again from 1995 to 2000.

Conclusions:

  • The overall rate of obstetric procedures did not increase in the 1990s, contrasting with the 1980s.
  • Despite a stable overall rate, the specific mix of obstetric procedures performed continued to evolve during the 1990s.