Associations between ethnicity and severe perineal trauma after vaginal birth

      It has been suggested that the risk of sustaining severe perineal trauma may vary by maternal ethnicity. We sought to explore this in a single health service. We reviewed the perineal outcome for women of different ethnicities having a vaginal birth in our service 2009–2012. Data were derived from the electronic Birthing Outcome System (BOS), an electronic maternity record completed for all women as part of State government birth reporting. In 2009–2102, among five selected ethnic groups 19,791 women had a vaginal birth: Australian-born (10,922 women), South Asian (4357), East Asian (1321), South East Asian (2800), and West Asian (391). Among these women, the normal vaginal birth rate differed significantly across ethnic groups (Australian: 81%, S Asian: 76%, East Asian: 76%, SE Asian: 82%, W Asian: 87%, P < 0.0001). Perineal outcomes also differed significantly between ethnic groups (e.g. intact perineum – Australian: 74%, S Asian: 62%, E Asian: 43%, SE Asian: 48%, W Asian: 67%, P < 0.0001; 3rd/4th degree tear – Australian: 3%, S Asian: 8%, E Asian: 7%, SE Asian: 6%, W Asian: 4%, P < 0.0001; episiotomy – Australian: 17%, S Asian: 29%, E Asian: 29%, SE Asian: 25%, W Asian: 14%, P < 0.0001). The rate of severe perineal trauma after vaginal birth varies with maternal ethnicity. Women of South/SE/East Asian birth have a higher rate of 3rd/4th degree tears and of episiotomy than Australian-born or West Asian women. These differences were not explained by differences in the need for assisted vaginal birth. Other possible contributors to the differing rates are under analysis.
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