Care pathways in obstetrics: The effectiveness in reducing the incidence of episiotomy in childbirth

Aim To develop a care pathway for childbirth. Background Care pathways are emerging as an effective tool to improve clinical and organizational performance. Methods A pre- and postimplementation analysis model was used to evaluate the effect of introducing a care pathway for childbirth. Key outcome indicators and costs were reviewed to compare the traditional care processes with those of the care pathway. The study involved 380 women. Results There was a significant reduction in episiotomy rate (from 14.90% to 8.6%, P = 0.02) in patients being cared for using a care pathway approach; however, there were no differences in caesarean section and in perineal wound rates. The average costs per patient on the care pathway were €1278.42 (£873.64) compared with €1,146.87 (£783.74) preimplementation. The study also demonstrated an increase in patient satisfaction for women cared for using the care pathway approach. Conclusions The care pathway proved to be a valid methodological approach to childbirth, allowing healthcare workers to efficiently share the care of the women, guaranteeing safe and effective care.