Training bolsters forceps use after graduation. (Vacuum Delivery Rates Unchanged).

DALLAS -- Emphasis upon teaching operative vaginal delivery techniques during residency appears to translate into increased use of these skills after entry into ob.gyn. practice, said Dr. Pamela A. Promecene of the University of Texas, Houston.

This educational emphasis may offer a means of curbing spiraling cesarean section rates, she said at the annual meeting of the Council on Resident Education in Obstetrics and Gynecology and the Association of Professors of Gynecology and Obstetrics.

Dr. Promecene surveyed 44 ob.gyns. who had completed their residency training during 1994-2000 through the university. The university's department of ob.gyn. provides a unique natural laboratory for studying the effects of residency training upon subsequent practice patterns because it oversees two separate and very distinct residency training programs in one city under a single chairman, she explained.

Residents at Lyndon B. Johnson (LBJ) General Hospital work primarily with an indigent Hispanic patient population. The C-section rate at that hospital is consistently under 10%. The rate of forceps-assisted delivery, at 10%, is relatively high, while the rate of vacuum-assisted delivery is less than 0.1%. No elective inductions are performed at the hospital.

In contrast, residents at Memorial Hermann Hospital work with a predominantly privately insured population composed of roughly equal numbers of whites, blacks, and Asian Americans.

The C-section rate there is consistently in excess of 20%. The rate of forceps-assisted deliveries is lower than at LBJ General Hospital, while the rate of vacuum- assisted deliveries is higher. ...