THE USE OF AN EPISIOTOMY IN RELATION TO THE PROFESSIONAL-EDUCATION OFTHE DELIVERY ATTENDANT

In a group of 1272 primiparous women, who delivered spontaneously at t he University Hospital of Leiden between 1 January 1988 and 31 Decembe r 1991, the relationship between the use of an episiotomy and the prof essional training of the delivery attendant has been studied, using mu ltiple logistic regression (a random effects model to allow for patien t-within-physician effects). The following factors were taken into acc ount: birthweight, duration of the second stage of labour, supposed fe tal distress, age and race of the mother, gestational age, duration of pregnancy and the year of the delivery. Based on the logistic regress ion model it is estimated that registrars and gynaecologists are 2.5 a nd 3.4 times, respectively, more likely than midwives to perform an ep isiotomy.