CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Multicenter Study
Episiotomy use among vaginal deliveries and the association with anal sphincter injury: a population-based retrospective cohort study.
The rate of obstetric anal sphincter injury has increased in recent years, particularly among operative vaginal deliveries. We sought to characterize temporal trends in episiotomy use and to quantify the association between episiotomy and obstetric anal sphincter injury. ⋯ Episiotomy use has declined in Canada for all vaginal deliveries. The protective association between episiotomy and obstetric anal sphincter injury among women who gave birth by operative vaginal delivery (especially forceps) warrants reconsideration of clinical practice among nulliparous women and those attempting vaginal birth after cesarean.