Seijmonsbergen-Schermers AE, van den Akker T, Rydahl E, et al. - Researchers analyzed variations in and correlations between commonly used childbirth interventions and adverse outcomes, adjusted for population characteristics. They assessed existing data on 4,729,307 singleton births at ≥ 37 weeks in 2013 from Finland, Sweden, Norway, Denmark, Iceland, Ireland, England, the Netherlands, Belgium, Germany (Hesse), Malta, the United States, and Chile in this multinational cross-sectional study to inscribe variations in childbirth interventions and outcomes. Observations revealed considerable intercountry variations for all interventions, even after adjustments for parity, maternal age, ethnicity, maternal BMI, education, and birth weight. They identified the largest variations for augmentation of labour, pain relief, episiotomy, instrumental vaginal birth, and CS. Higher rates of births with a spontaneous onset, spontaneous vaginal births among multiparous women, and instrumental vaginal births and lower rates of induction of labor, prelabor CS, episiotomy among multiparous women, and overall CS were reported in countries with a higher rate of births at ≥ 42 weeks’ gestation. Countries with higher rates of births with a spontaneous onset had lower rates of induction of labor, prelabor CS, overall CS, and emergency CS (nulliparous women only) and had higher rates of spontaneous vaginal births among multiparous women. Lower rates of pain medication were observed among nulliparous women in countries with lower rates of out-of-hospital births. Strong correlation was observed of variation in the overall CS rate with variation in prelabor CS, and a positive correlation was noted between prelabour CS and emergency CS among nulliparous women. In countries with higher rates of spontaneous vaginal birth, higher rates of OASI in vaginal births were observed among nulliparous women. In countries with higher rates of epidural anesthesia, they noted higher rates of Apgar score < 7 among nulliparous women and higher rates of spontaneous vaginal births among multiparous women. No significant difference was noted in perinatal mortality rates up to 7 days.