Use of routine interventions in vaginal labor and birth: findings from the Maternity Experiences Survey.
BACKGROUND
Intervention rates in maternity practices vary considerably across Canadian provinces and territories. The objective of this study was to describe the use of routine interventions and practices in labor and birth as reported by women in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System. Rates of interventions and practices are considered in the light of current evidence and both Canadian and international recommendations.


METHODS
A sample of 8,244 estimated eligible women was identified from a randomly selected sample of recently born infants drawn from the May 2006 Canadian Census and stratified primarily by province and territory. Birth mothers living with their infants at the time of interview were invited to participate in a computer-assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews averaged 45 minutes long and were completed when infants were between 5 and 10 months old (9-14 mo in the territories). Completed responses were obtained from 6,421 women (78%).


RESULTS
Women frequently reported electronic fetal monitoring, a health care practitioner starting or speeding up their labor (or trying to do so), epidural anesthesia, episiotomy, and a supine position for birth. Some women also reported pubic or perineal shaves, enemas, and pushing on the top of their abdomen.


CONCLUSIONS
Several practices and interventions were commonly reported in labor and birth in Canada, although evidence and Canadian and international guidelines recommend against their routine use. Practices not recommended for use at all, such as shaving, were also reported.
Chalmers
Beverley
B
Ottawa Hospital Research Institute at the University of Ottawa, Ontario, Canada.
Kaczorowski
Janusz
J
Levitt
Cheryl
C
Dzakpasu
Susie
S
O'Brien
Beverley
B
Lee
Lily
L
Boscoe
Madeline
M
Young
David
D
D000328:Adult; D015360:Analgesia, Epidural / Q000706:statistics & numerical data; D002170:Canada; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data*; D004733:Enema / Q000706:statistics & numerical data; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D005323:Fetal Monitoring / Q000706:statistics & numerical data; D006204:Hair Removal / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data; D007743:Labor, Obstetric; D009772:Obstetrical Forceps / Q000706:statistics & numerical data; D036801:Parturition; D011187:Posture; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D014620:Vacuum Extraction, Obstetrical / Q000706:statistics & numerical data; D055815:Young Adult