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Abstract
Objective: To investigate the relationship between the practices of obstetric intervention in individual units. Study design: A retrospective analysis of the annual statistical returns to the Royal College of Obstetricians and Gynaecologists of 222 units in the UK for 1997-98. Results: A total of 212 units that delivered more than 1000 babies were analyzed. A positive correlation was found between the rates of assisted vaginal delivery and emergency Cesarean section (Spearman's rho = 0.207, p = 0.003) and the rates of emergency and elective Cesarean section (Spearman's rho = 0.205, p < 0.001). There was a significant difference between unit size and the rate of spontaneous vaginal delivery (Kruskall-Wallis χ2 = 14.5, p = 0.002) with larger units having a lower spontaneous vaginal delivery rate. Conclusion: These results indicate that those units which have a high emergency Cesarean section rate also have a high elective Cesarean section rate and assisted vaginal delivery rate. The philosophy of an individual unit towards intervention is a general philosophy and determines the intervention rates for all procedures.