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

ABSTRACT

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.