Numbers and rates of women with an episiotomy by mode of delivery and by maternal and infant characteristics, among all term singleton vaginal deliveries with information on parity, Canada, 2004–2017*
| Characteristic | Nulliparous | Parous, no previous CD | VBAC | ||||||
|---|---|---|---|---|---|---|---|---|---|
| No. deliveries | With episiotomy | No. deliveries | With episiotomy | No. deliveries | With episiotomy | ||||
| No. | Rate % | No. | Rate % | No. | Rate % | ||||
| All vaginal deliveries | 850 776 | 217 252 | 25.5 | 1 079 282 | 72 976 | 6.8 | 68 560 | 11 240 | 16.4 |
| Spontaneous | 641 809 | 107 564 | 16.8 | 1 016 324 | 57 281 | 5.6 | 55 724 | 5891 | 10.6 |
| Operative | |||||||||
| Forceps | 55 403 | 38 185 | 68.9 | 7906 | 3845 | 48.6 | 3194 | 1963 | 61.5 |
| Vacuum | 141 779 | 63 069 | 44.5 | 53 007 | 10 887 | 20.5 | 9065 | 3023 | 33.3 |
| Sequential | 11 785 | 8434 | 71.6 | 2045 | 963 | 47.1 | 577 | 363 | 62.9 |
| Maternal age, yr | |||||||||
| < 20 | 74 434 | 14 270 | 19.2 | 13 750 | 440 | 3.2 | 499 | 83 | 16.6 |
| 20–24 | 178 828 | 40 491 | 22.6 | 129 787 | 5126 | 4.0 | 6165 | 923 | 15.0 |
| 25–29 | 288 212 | 75 198 | 26.1 | 303 427 | 17 561 | 5.8 | 17 784 | 2843 | 16.0 |
| 30–34 | 228 937 | 63 407 | 27.7 | 392 350 | 29 248 | 7.5 | 26 654 | 4497 | 16.9 |
| 35–39 | 69 782 | 20 583 | 29.5 | 201 141 | 16 968 | 8.4 | 14 751 | 2490 | 16.9 |
| 40–44 | 10 191 | 3164 | 31.1 | 37 267 | 3479 | 9.3 | 2594 | 389 | 15.0 |
| ≥ 45 | 392 | 139 | 35.5 | 1560 | 154 | 9.9 | 113 | 15 | 13.3 |
| Parity | |||||||||
| 1 | 0 | 0 | 0.0 | 656 968 | 59 046 | 9.0 | 37 035 | 8820 | 23.8 |
| 2–3 | 0 | 0 | 0.0 | 357 759 | 13 130 | 3.7 | 25 152 | 2284 | 9.1 |
| ≥ 4 | 0 | 0 | 0.0 | 64 555 | 800 | 1.2 | 6373 | 136 | 2.1 |
| Induction | |||||||||
| Yes | 213 603 | 57 151 | 26.8 | 246 704 | 17 712 | 7.2 | 12 234 | 1816 | 14.8 |
| No | 637 173 | 160 101 | 25.1 | 832 578 | 55 264 | 6.6 | 56 326 | 9424 | 16.7 |
| Epidural | |||||||||
| Yes | 475 661 | 125 166 | 26.3 | 410 859 | 31 809 | 7.7 | 34 152 | 6281 | 18.4 |
| No | 375 115 | 92 086 | 24.6 | 668 423 | 41 167 | 6.2 | 34 408 | 4959 | 14.4 |
| Prolonged second stage | |||||||||
| Yes | 69 449 | 30 014 | 43.2 | 13 098 | 2568 | 19.6 | 4190 | 1387 | 33.1 |
| No | 781 327 | 187 238 | 24.0 | 1 066 184 | 70 408 | 6.6 | 64 370 | 9853 | 15.3 |
| Fetal distress, yes | |||||||||
| Yes | 262 927 | 91 783 | 34.9 | 189 225 | 20 659 | 10.9 | 19 652 | 4898 | 24.9 |
| No | 587 849 | 125 469 | 21.3 | 890 057 | 52 317 | 5.9 | 48 908 | 6342 | 13.0 |
| Birth weight, g | |||||||||
| < 2500 | 17 497 | 3571 | 20.4 | 14 095 | 719 | 5.1 | 1018 | 160 | 15.7 |
| 2500–2499 | 147 985 | 34 302 | 23.2 | 135 708 | 8019 | 5.9 | 9740 | 1580 | 16.2 |
| 3000–3499 | 365 026 | 90 424 | 24.8 | 410 690 | 26 184 | 6.4 | 27 044 | 4371 | 16.2 |
| 3500–3999 | 252 678 | 68 037 | 26.9 | 371 720 | 25 831 | 7.0 | 22 726 | 3767 | 16.6 |
| 4000–4499 | 60 461 | 18 438 | 30.5 | 125 098 | 10 055 | 8.0 | 6845 | 1163 | 17.0 |
| ≥ 4500 | 7129 | 2480 | 34.8 | 21 971 | 2168 | 9.9 | 1187 | 199 | 16.8 |
Note: CD = cesarean delivery, VBAC = vaginal birth after cesarean.
↵* P value for all bivariable comparisons < 0.0001; derived from Χ2 test for difference in proportion of maternal or infant characteristics among deliveries with and without episiotomy in each respective parity and obstetric history group.