title: The philosophy of practice governs the rate of obstetric intervention: analysis of 212 units in the United Kingdom.
abstract: OBJECTIVE
  To investigate the relationship between the practices of obstetric intervention in individual units.
  
  
  METHODS
  A retrospective analysis of the annual statistical returns to the Royal College of Obstetricians and Gynaecologists of 222 units in the UK for 1997-98.
  
  
  RESULTS
  A total of 212 units that delivered more than 1000 babies were analyzed. A positive correlation was found between the rates of assisted vaginal delivery and emergency Cesarean section (Spearman's rho = 0.207, p = 0.003) and the rates of emergency and elective Cesarean section (Spearman's rho = 0.205, p < 0.001). There was a significant difference between unit size and the rate of spontaneous vaginal delivery (Kruskall-Wallis chi2 = 14.5, p = 0.002) with larger units having a lower spontaneous vaginal delivery rate.
  
  
  CONCLUSIONS
  These results indicate that those units which have a high emergency Cesarean section rate also have a high elective Cesarean section rate and assisted vaginal delivery rate. The philosophy of an individual unit towards intervention is a general philosophy and determines the intervention rates for all procedures.
authors.affiliation: Coombe Women's Hospital, Dublin, Republic of Ireland.
authors.forename: M P
authors.initials: MP
authors.lastname: O'Connell
authors.forename: E M
authors.initials: EM
authors.lastname: Gurney
authors.forename: S W
authors.initials: SW
authors.lastname: Lindow
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D012189:Retrospective Studies; D006113:United Kingdom