Staff Training Reduces Postpartum Bleeding, Episiotomies

(Page 2)

At the end of 18 months, the researchers looked at records on the 5,466 vaginal births that took place at the 10 hospitals using the new guidelines and nine control hospitals where no new birthing recommendations were made. Oxytocin use rose from 2.1 percent of births to 83.6 percent at the 10 hospitals participating in the workshops. Oxytocin use increased only from 2.6 percent to 12.3 percent at the control hospitals.

Episiotomies dropped from 41.1 percent of births to 29.9 percent at hospitals receiving the staff instruction; they rose slightly -- from 43.5 percent to 44.5 percent -- at the control hospitals.

The hospitals where the staff received the instruction also had a 45 percent reduction in postpartum hemorrhages of 500 milliliters (2 cups) or more, and a 70 percent reduction on postpartum hemorrhage of 1,000 milliliters (4 cups) or more.

After a year, oxytocin use remained high (73.4 percent) at hospitals participating in the workshops instruction and low in control hospitals (7.1 percent). Also, the episiotomy rate at hospitals receiving the instruction remained relatively stable at each.

Given the results, the researchers suggested that getting health professionals to adopt a new practice (using oxytocin) may be easier than getting them to eliminate an established practice (episiotomy use).

More information

The Agency for Healthcare Research and Quality has more about having an episiotomy.