Variation in Obstetric Interventions by Midwife

This paper reports variation in birth interventions by 25 midwives among 2,135 births in a Finnish hospital. The rate of cesarean sections varied from 0 to 18%, and that of instrumental deliveries from 0 to 8%. Mother's and infant's characteristics and rates of vaginal breeches suggest that a low rate of cesarean sections was not explained only by selection to easy births. This study suggests that the skills, attitudes and routines of midwives may explain part of the variation found in birth interventions.