Individual consultant practice does not affect the overall intervention rate: a 6-year study

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Differences exist in obstetric intervention rates between hospitals but it is not known if the individual consultant governs the decision to intervene or whether intervention is a product of agreed protocols and working practices. The purpose of this study is to analyse the differences in obstetric intervention rates amongst individual consultants working in a large maternity unit.


Each consultant was responsible for all deliveries occurring in successive 24-h periods. Over a 6-year period all deliveries resulting from a spontaneous onset of labour were matched to the consultant in charge at the time of the delivery and analysed.


There were no differences seen in normal delivery rates (χ2=4.478, P=0.812) and vacuum (χ2=12.232, P=0.141) rates for the consultants. Significant differences were found in both forceps rate (χ2=21.462, P=0.006) and caesarean rate (χ2=24.535, P=0.002) between consultants. When the forceps rate was combined with vacuum rate there were no significant differences.


Within the hospital, individual consultants demonstrated no significant variations in overall intervention rates. However, when intervention occurred, different consultants showed preferences for forceps and caesarean section.

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