Related Experiment Video
Updated: Jul 20, 2026
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
The Philadelphia Episiotomy Intervention Study
Jay Goldberg1, Patricia Purfield, Nancy Roberts
1Department of Obstetrics and Gynecology, and Biostatistics Section, Division of Clinical Pharmacology, Jefferson Medical College, 834 Chestnut Street, Suite 400, Philadelphia, PA 19107, USA. jaygoldbergmd@yahoo.com
Objective:
To lower the episiotomy rate through physician education and documentation of indication when episiotomy was performed.
Study Design:
The intervention consisted of an evidence-based lecture recommending limited usage of episiotomy and requesting documentation of any episiotomy's indication. Data 3 months prior to the intervention were compared to those of the year following. Adjusted comparisons of episiotomy rates were completed using multivariate logistic regression models.
Results:
For all vaginal deliveries, there was a 17% decrease in the rate of episiotomy, from 46.9% to 38.8%. For spontaneous vaginal deliveries, there was a 25% decrease in the episiotomy rate, from 40.8% to 30.8%. The most common indications for episiotomy reported were routine/elective, 41.0%; vacuum, 18.6%; forceps, 16.4%; and nonreassuring fetal heart tracing, 10.9%.
Conclusion:
Episiotomy rates may be effectively reduced through physician education and documentation of procedure indication.