31 Regional variations in childbirth interventions in the Netherlands Compared to the other interventions, least variation was found for intrapartum CS and instrumental vaginal birth for women without prelabour CS (figures 7a and b). Intrapartum CS rates varied from between 12.7% to 15.4% (nulliparous women) and from between 5.3% to 6.4% (multiparous women), and instrumental birth rates varied from between 16.2% to 19.4% (nulliparous women) and from between 3.1% to 4.2% (multiparous women) (table 2). For midwife-led care, regions with higher intrapartum CS rates had higher instrumental birth rates as well (ρ = 0.60), but this correlation was not significant in obstetrician-led care at the onset labour (ρ = 0.45; table 6). For all nulliparous women, a variation of spontaneous vaginal birth rates was found of between 62.4% and 67.4%, and for multiparous women, of between 81.7% and 86.1% (table 2). 2
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