U.S. Trends in Obstetric Procedures, 1990–2000

Authors

  • Lola Jean Kozak PhD,

    1. Lola Jean Kozak is a health statistician in the Hospital Care Statistics Branch, Division of Health Care Statistics, and Julie Dawson Weeks is a health statistician and project director of the Longitudinal Studies of Aging in the Population Epidemiology Branch, Division of Epidemiology, Office of Analysis, Epidemiology and Health Promotion, National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Hyattsville, Maryland.
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  • Julie Dawson Weeks PhD

    1. Lola Jean Kozak is a health statistician in the Hospital Care Statistics Branch, Division of Health Care Statistics, and Julie Dawson Weeks is a health statistician and project director of the Longitudinal Studies of Aging in the Population Epidemiology Branch, Division of Epidemiology, Office of Analysis, Epidemiology and Health Promotion, National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Hyattsville, Maryland.
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Address correspondence to Lola Jean Kozak, PhD, National Center for Health Statistics, 6525 Belcrest Road, Room 952, Hyattsville, Maryland 20782.

Abstract

ABSTRACT: 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. (BIRTH 29:3 September2002)

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