U.S. trends in obstetric procedures, 1990-2000.
BACKGROUND
During the 1980s the rate of obstetric procedures performed during delivery rose precipitously. This study follows the use of obstetric procedures through the 1990s to explore whether the patterns witnessed in the previous decade continued through the next.


METHODS
Data on total obstetric procedures and eight specific procedures (cesarean section, medical and surgical induction of labor, other artificial rupture of membranes, episiotomy, repair of current obstetric laceration, vacuum extraction, forceps delivery) were obtained from the National Hospital Discharge Survey, a nationally representative survey of discharges from short-stay non-Federal hospitals. Approximately 32,000 records for women with deliveries were included in the survey each year.


RESULTS
The total rate of all obstetric procedures did not change significantly from 1990 through 2000. However, as during the 1980s, rates increased for induction of labor, vacuum extraction, and repair of current obstetric laceration. Rates decreased for forceps delivery and episiotomy, also continuing 1980s trends. After a long period of increase, the rate of cesarean section declined from 1988 to 1995 but increased again from 1995 to 2000.


CONCLUSIONS
Unlike the 1980s, the overall rate of obstetric procedures did not increase from 1990 to 2000, but the mix of obstetric procedures performed continued to change during this period.
Kozak
Lola Jean
LJ
Hospital Care Statistics Branch, Division of Health Care Statistics, National Center for Health Statistics, Hyattsville, Maryland 20782, USA.
Weeks
Julie Dawson
JD
D002585:Cesarean Section / Q000706:statistics & numerical data; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data; D008499:Medical Records; D013513:Obstetric Surgical Procedures / Q000706:statistics & numerical data*; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014620:Vacuum Extraction, Obstetrical / Q000706:statistics & numerical data; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data