Answers to a questionnaire on perinatal practices in countries of the WHO European region revealed rates of operative delivery ranging from about 6 to 24%. When the caesarean section rates were compared with the rates of forceps and vacuum extraction for each country, no systematic trend was found. There was a slight negative correlation between the frequencies of operative delivery and national perinatal mortality rates, but this accounts for only a small amount of the inter-country variation in perinatal mortality rates. The frequencies of induction of labour ranged from 12 to 36% in four countries with reliable national data. Relatively few European countries have population-based statistical data on the frequencies of caesarean section, forceps delivery and vacuum extractions. The national recording of induction of labour is unusual. Considering the medical and psycho-social impact of these procedures, we suggest national or regional monitoring.
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