title: Family physician and obstetrician episiotomy rates in low-risk obstetrics in southern Alberta.
abstract: OBJECTIVE
  To examine the episiotomy rate for women delivering in a regional hospital versus the rate in rural hospitals.
  
  
  METHODS
  Retrospective review of low-risk delivery charts for a 12-month period (2006 to 2007).
  
  
  METHODS
  One regional and 3 rural hospitals in southern Alberta.
  
  
  METHODS
  Charts were reviewed for a random sample of 10% of the women with low-risk deliveries at the regional hospital, and all such women at the participating rural hospitals. Eligible women were nulliparous or multiparous, were at 37 or more weeks' gestation, and delivered live newborns vaginally, including spontaneous and assisted vaginal deliveries. Low-risk deliveries were defined by the absence of high-risk maternal, prenatal, and perinatal features.
  
  
  METHODS
  Details of the delivery, including use of episiotomy.
  
  
  RESULTS
  Charts were reviewed for 115 women who delivered in the regional hospital and for 140 women from the rural hospitals. Maternal and infant characteristics did not differ between settings (mean age 26 years, median parity 1, mean birth weight 3433 g [regional] and 3462 g [rural], and mean head circumference 35 cm). Episiotomies were performed in 13% of regional and 4% of rural deliveries (P = .01). Perineal tears occurred in 65% of regional (3 with third- to fourth-degree tears) and 57% of rural (2 with third- to fourth-degree tears) deliveries (P = .20). Deliveries were carried out by 12 FPs and 6 obstetricians in the regional centre, and by 19 FPs in the rural hospitals.
  
  
  CONCLUSIONS
  In our study, both rural and regional practitioners in southern Alberta demonstrated a "restrictive" use of episiotomy, in keeping with current evidence-based guidelines. Further prospective research is needed to examine how physician, maternal, and pregnancy characteristics affect episiotomy and perineal tear rates.
authors.affiliation: South Alberta Rural Residency Program, University of Calgary, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Hargrove
authors.forename: Kristy
authors.initials: K
authors.lastname: Penner
authors.forename: Tyler
authors.initials: T
authors.lastname: Williamson
authors.forename: Sue
authors.initials: S
authors.lastname: Ross
mesh_terms: D000328:Adult; D000416:Alberta; D004841:Episiotomy / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006801:Humans; D009774:Obstetrics / Q000706:statistics & numerical data*; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult