Department of Obstetrics and Gynaecology, Ottawa Hospital Research Institute at the University of Ottawa, Ontario.
Birth. 2012 Sep;39(3):203-10. doi: 10.1111/j.1523-536X.2012.00549.x. Epub 2012 Jun 27.
Rates of interventions in labor and birth should be similar across a country if evidence-based practice guidelines are followed. This assumption is tested by comparison of some practices across the 13 provinces and territories of Canada. The objective of this study was to describe the wide provincial and territorial variations in rates of routine interventions and practices during labor and birth as reported by women in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System.
A sample of 8,244 eligible women was identified from a randomly selected sample of recently born infants drawn from the May 2006 Canadian Census. The sample was stratified by province and territory. Computer-assisted telephone interviews were conducted with participating birth mothers by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews took an average of 45 minutes 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%).
Provincial and territorial variations in rates of routine intervention used during labor and birth are reported. The percentage range of mothers' experience of induction (range 30.9%), epidural (53.7%), continuous electronic fetal monitoring (37.9%), and medication-free pain management during labor (40.7%) are provided, in addition to the use of episiotomy (14.1%) or "stitches" (48.3%), being in a "flat lying position" (42.2%), and having their legs in stirrups for birth (35.7%). Wide variations in the use of most of the interventions were found, ranging from 14.1 percent to 53.7 percent.
Rates of intervention in labor and birth showed considerable variation across Canada, suggesting that usage is not always evidence based but may be influenced by a variety of other factors.
如果遵循基于证据的实践指南，那么一个国家的分娩干预率应该相似。通过比较加拿大 13 个省和地区的一些做法来检验这一假设。本研究的目的是描述在加拿大围产期监测系统的产妇经历调查中报告的分娩期间常规干预和做法的广泛省际和地区差异。
从 2006 年 5 月加拿大人口普查中抽取的最近出生婴儿的随机样本中确定了 8244 名合格妇女的样本。该样本按省和地区分层。加拿大统计局代表加拿大公共卫生署通过计算机辅助电话采访了参与分娩的母亲。采访平均需要 45 分钟，在婴儿 5 至 10 个月大时（在领土上为 9 至 14 个月）进行。从 6421 名妇女（78%）中获得了完整的回复。
报告了分娩期间常规干预措施的省际和地区差异。提供了诱导（范围 30.9%）、硬膜外（53.7%）、连续电子胎儿监测（37.9%）和分娩期间无药物止痛管理（40.7%）的母亲经验百分比范围，以及会阴切开术（14.1%）或“缝线”（48.3%）、“平卧位”（42.2%）和腿部置于分娩支架中（35.7%）的使用情况。大多数干预措施的使用差异很大，范围从 14.1%到 53.7%。
分娩干预率在加拿大各地存在相当大的差异，这表明使用率并非总是基于证据，而是可能受到多种其他因素的影响。
