Evolution of Episiotomy Incidence and Obstetric Anal Sphincter Injury Over 10 Years: A Mixed-Methods Study.

Objective: To assess the association between the decrease in the use of episiotomy and the incidence of obstetric anal sphincter injuries (OASIS) over a 10-year period and understand their reasons by interviewing obstetricians and midwives.

Design: Mixed-methods study.

Setting: A tertiary university public maternity hospital, Paris, France.

Ignoring international alerts? The routinization of episiotomy in France in the 1980s and 1990s.

As scientific evidence from the UK and the USA in the 1980s was questioning the usefulness of episiotomy, the rate in France increased from 38% in 1981 to 58.4% in 1996. In 1996, the World Health Organization recommended limiting the episiotomy rate to 10%.