Are physicians changing the way they practise obstetrics?
” Canadian Medical Association Journal 148:409-15. OBJECTIVE: To examine trends in obstetric interventions in women at low risk over approximately 3 years. It was postulated that there would be a general reduction in most intervention rates. DESIGN: Retrospective review of hospital records. SETTING: Three downtown hospitals of the University of Toronto, in which academic and nonacademic family physicians and obstetricians practised. PATIENTS: A total of 2365 women in phase 1 (April 1985 to March 1986) and 1277 in phase 2 (May to September 1988) met the inclusion criteria for grade A (pregnancy at no predictable risk) of the Ontario Antenatal Record at the time of admission to hospital. OUTCOME MEASURES: Rates of artificial rupture of the membranes, induction, augmentation, epidural anesthesia, continuous electronic fetal monitoring (EFM), instrumental delivery, episiotomy and cesarean section. RESULTS: The family physicians and the obstetricians had significant decreases (p 0.01) over
