The use of an episiotomy in relation to the professional education of the delivery attendant.

In a group of 1272 primiparous women, who delivered spontaneously at the University Hospital of Leiden between 1 January 1988 and 31 December 1991, the relationship between the use of an episiotomy and the professional training of the delivery attendant has been studied, using multiple logistic regression (a random effects model to allow for patient-within-physician effects). The following factors were taken into account: birthweight, duration of the second stage of labour, supposed fetal distress, age and race of the mother, gestational age, duration of pregnancy and the year of the delivery. Based on the logistic regression model it is estimated that registrars and gynaecologists are 2.5 and 3.4 times, respectively, more likely than midwives to perform an episiotomy.