(HealthDay News) — The incidence of episiotomy has been declining since the 1990s because of concerns regarding related risks and benefits, researchers report in the January 13 issue of the Journal of the American Medical Association.

To assess current rates, study author Alexander Friedman, MD, and his colleagues at the Columbia University College of Physicians and Surgeons in New York City, examined data on 2,261,070 American women who had vaginal deliveries at 510 different facilities between 2006–2012. Overall, 14.4% underwent an episiotomy during that period.

In 2006, 17.3% of deliveries involved the surgery, compared to 11.4% in 2012. But some hospitals perform significantly more episiotomies than others, the researchers said. Among the 10% of hospitals that most often performed the surgery, episiotomies were performed among 34.1% of births. But in the 10% of hospitals where it was least popular, the procedure was applied in 2.5% of births.

White women were almost twice as likely as black women to undergo an episiotomy, the data indicated. And women with private insurance were more likely than those with Medicaid to have the procedure. “These observations suggest nonmedical factors are related to use of episiotomy,” the authors write.

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