The Dutch obstetric intervention study — variations in practice patterns

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Abstract
Objective: To compare obstetric intervention rates between Dutch hospitals. Methods: A total of 28 934 hospital births under secondary care (specialist care for medium‐/high‐risk pregnancies) in 1990 were analyzed in a stratified, random sample of Dutch hospitals based on the records of the Dutch Netherlands perinatal database. Comparisons were made of the intervention rates between hospitals. Results: The intervention rates of the various hospitals differed widely. The most striking difference was in the cesarean section (CS) rate for non‐vertex first twins, with a range of 0–100% and a mean rate of 47.6%. On average a CS for a term breech was performed in 30.8% of cases and sedation or analgesics were administered in 16.2% of cases. The mean rate of episiotomy for a term breech was 71.5%, the lowest rate being 18.8%. Conclusion: Our results show relatively low intervention rates with considerable interhospital variation.