National Women's Annual Clinical Report 2010

2010. Private obstetricians have the highest episiotomy rates but the lowest 3rd and 4th
degree tear rates.
Last year’s report highlighted the fact that the internationally published incidence for 3rd and
4th degree tears is up to 6% of all vaginal births 1 . However, up to 40% of women who sustain
an anal sphincter injury report problems with anal incontinence six months after birth 2 and
approximately 10% of those may need a secondary repair of their anal sphincter 1 .
1
Uustal Fornell E et al. Obstetric anal sphincter injury ten years after: subjective and objective long term effects. Br J Obstet
Gynaecol 2005; 112: 312-316
2
Fornell EK et al. Clinical consequences of anal sphincter rupture during vaginal birth. J Am Coll Surg 1996; 183: 553-558
%
50
40
30
20
10
0
Independent MW Private Obstetrician NW
Nullipara Multipara
Figure 65: Episiotomy rate in spontaneous cephalic vaginal birth by LMC at birth and parity (with
95% confidence intervals)
6
5
4
3
2
1
0
%
Independent Midwife Private Obstetrician NW
Nullipara Multipara
Figure 66: 3 rd and 4 th degree tear rate in spontaneous vaginal birth by LMC at birth and parity
(with 95% confidence intervals)
106