Decrease reported in inpatient ob/gyn procedures

The overall number of obstetric and gynecologic procedures performed in the United States has decreased from about 5.3 million in 1979 to 4.9 million in 2006, according to an analysis of data from the National Hospital Discharge Survey of US inpatient hospitals. All gynecologic procedure rates decreased during this period except incontinence procedures, which increased. Among obstetric procedures, both operative vaginal delivery and episiotomy rates decreased; however, cesarean delivery rates increased dramatically, and spontaneous vaginal delivery rates also rose.

The more than 137 million obstetric and gynecologic procedures performed during the study period represented 26.5% of surgical procedures performed in adult women. In addition, obstetric- and gynecologic-related procedures accounted for most of the top 10 of all inpatient surgical procedures in women across the study period. Of the total obstetric/gynecologic procedures, 64% were solely obstetric and 29% solely gynecologic; 7% of women had both an obstetric and a gynecologic procedure during the same inpatient admission. The 5 most common surgical procedures in 2006 were, in order, repair of obstetric laceration, low-transverse cesarean delivery, manually assisted delivery, blood transfusion, and artificial rupture of membranes. In 1979, they were episiotomy, dilation and curettage, total abdominal hysterectomy, and low forceps with episiotomy.

In women younger than 40 years old, the most common procedure was spontaneous vaginal delivery. The most common procedure among women between the ages of 40 and 69 years was hysterectomy, and pelvic organ prolapse repair topped the list of surgical procedures common among women 70 years old and older.