Use of Episiotomy Varies Widely Among U.S. Hospitals

Episiotomy is a surgical incision, usually made with scissors, of the posterior perineum just before vaginal birth with the goals of reducing likelihood of spontaneous explosive, radiating perineal trauma while hastening the final stage of delivery. In 2006, the American College of Obstetricians and Gynecologists recommended against the routine practice of episiotomy. A 2009 Cochrane review showed that restricting use of episiotomy was associated with less posterior perineal trauma (including fewer anal sphincter lacerations) but more spontaneous anterior perineal trauma (Cochrane Database Syst Rev 2009; CD000081). Now, investigators have analyzed vaginal delivery data from 2006 through 2012 in the Perspective insurance database (which incl…