Episiotomy: beliefs, practice and the impact of educational intervention.
OBJECTIVE
To assess the potential effect of educational intervention on episiotomy practice.


METHODS
A survey of the attitude of obstetrical caregivers toward episiotomy was conducted among obstetricians and midwives in the three public hospitals in Haifa. Data regarding episiotomy rates was collected for the years 2001-2003. At the beginning of 2002, lectures on the risks and benefits of episiotomy were given in two hospitals. Episiotomy rates before and after the lecture were compared.


RESULTS
A significant and lasting reduction in episiotomy rates was observed in the two hospitals where lectures were given. There were no clinically significant and consistent changes in the episiotomy practices in the third hospital.


CONCLUSIONS
Education may play an important role in changing common medical practices, as in episiotomy. It was clearly shown that our beliefs are not always up to date. We call for periodic reassessment of all medical procedures, as common and accepted as they are.
Löwenstein
Lior
L
Department of Obstetrics and Gynecology, Rambam Medical Center, POB 9602, Haifa 31096, Israel. l_lior@rambam.health.gov.il
Drugan
Arie
A
Gonen
Ron
R
Itskovitz-Eldor
Joseph
J
Bardicef
Mordechai
M
Jakobi
Peter
P
D001291:Attitude of Health Personnel; D004501:Education, Medical / Q000379:methods; D004841:Episiotomy / Q000193:education* / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency; D007557:Israel / Q000453:epidemiology; D022125:Lacerations / Q000517:prevention & control; D008880:Midwifery; D007744:Obstetric Labor Complications / Q000517:prevention & control*; D009774:Obstetrics; D010502:Perineum; D011247:Pregnancy; D011364:Professional Practice / Q000706:statistics & numerical data* / Q000639:trends