Differences and trends in obstetric interventions at term among urban and rural women in New South Wales: 1990-1997

The aim of this study was to compare the management of term births among ru ral and urban women, including the effect of indigenous status and out-of-a rea-birth for rural women. Data were obtained from the NSW Midwives Data Co llection (MDC), on 619,298 women who gave birth to a live, singleton infant at term (37-45 weeks gestation) from 1 January 1990 to 31 December 1997. C ompared with urban non-indigenous women, rural women and indigenous women h ad lower rates of obstetric interventions both before birth (induction of l abour, planned Caesarean section and epidural) and at the time of birth (Ca esarean after labour, instrumental delivery and episiotomy). This was espec ially true for rural women giving birth in the their local area. The differ ing pregnancy risk profile of rural women did not explain the differences i n intervention rates but differences were partly explained by higher rates of epidural anaesthesia in urban areas.