Use of Routine Interventions in Vaginal Labor and Birth: Findings from the Maternity Experiences Survey

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Abstract:

ABSTRACT: 

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. (BIRTH 36:1 March 2009)

Keywords: birth; interventions; labor; maternity experiences

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1523-536X.2008.00291.x

Affiliations: 1: Janusz Kaczorowski is a Professor and a Research Director in the Department of Family Practice at the University of British Columbia, Vancouver, British Columbia 2: Cheryl Levitt is a Professor in the Department of Family Medicine at McMaster University, Hamilton, Ontario 3: Susie Dzakpasu is an Epidemiologist in the Maternal and Infant Health Section of the Public Health Agency of Canada, Ottawa, Ontario 4: Beverley O’Brien is a Professor in the Faculty of Nursing at the University of Alberta, Edmonton, Alberta 5: Lily Lee is a Perinatal Nurse Consultant in the British Columbia Perinatal Health Program, Vancouver, British Columbia 6: Madeline Boscoe is the Executive Director of the Canadian Women’s Health Network, Winnipeg, Manitoba 7: David Young is a Professor in the Department of Obstetrics and Gynecology at Dalhousie University, Halifax, Nova Scotia, Canada.

Publication date: March 1, 2009

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