Uploaded January 2022 | Updated September 2026, 2 weeks ago
Description:
In industrialized settings, where obstetric intervention has increased significantly in recent decades, the discourse surrounding contemporary birth practices is often framed ideologically as a matter of nature versus technology. The rise in cesarean delivery rates, in particular, is at the very centre of this discourse. Only 5% of Canadian women delivered by cesarean delivery in the 1960s, but cesarean deliveries account for approximately 28% of deliveries currently. This increase in cesarean delivery has occurred concomitantly with a decline in forceps- and vacuum-assisted delivery. This inverse relationship has led to recommendations to increase the use of forceps and vacuum as a strategy to reduce cesarean deliveries. Forceps and vacuum are considered safe if carried out by trained personnel; however, opportunities for training in forceps and vacuum have declined, and the safety of these deliveries given these shifts in practice warrants inquiry.
Learning objectives:
- Explore the trends and comparative outcomes among operative vaginal and cesarean delivery using regression and propensity score analyses;
- Quantify population-level impacts of increasing operative vaginal delivery rates using ecological studies; and
- Investigate the safety of operative vaginal deliveries in hospitals across Canada using multi-level, standardized and adjusted models, with special emphasis on the incidence of maternal and neonatal trauma.
Description:
In industrialized settings, where obstetric intervention has increased significantly in recent decades, the discourse surrounding contemporary birth practices is often framed ideologically as a matter of nature versus technology. The rise in cesarean delivery rates, in particular, is at the very centre of this discourse. Only 5% of Canadian women delivered by cesarean delivery in the 1960s, but cesarean deliveries account for approximately 28% of deliveries currently. This increase in cesarean delivery has occurred concomitantly with a decline in forceps- and vacuum-assisted delivery. This inverse relationship has led to recommendations to increase the use of forceps and vacuum as a strategy to reduce cesarean deliveries. Forceps and vacuum are considered safe if carried out by trained personnel; however, opportunities for training in forceps and vacuum have declined, and the safety of these deliveries given these shifts in practice warrants inquiry.
Learning objectives:
- Explore the trends and comparative outcomes among operative vaginal and cesarean delivery using regression and propensity score analyses;
- Quantify population-level impacts of increasing operative vaginal delivery rates using ecological studies; and
- Investigate the safety of operative vaginal deliveries in hospitals across Canada using multi-level, standardized and adjusted models, with special emphasis on the incidence of maternal and neonatal trauma.
