Abstract
Purpose
Caesarean delivery in the absence of any medical indications has become a major issue of concern among the women’s health professionals. The patients’ choice of caesarean is influenced by several factors predominating by their physicians’ suggestion. Our objective was to examine factors that may affect the physicians’ responses to patients consulting the mode of delivery.
Methods
Questionnaires were posted to 1,000 female obstetricians and gynaecologists practicing in Tehran in winter 2007. Questionnaires included demographic information of physicians and their history of pregnancy and delivery. Finally, they were asked their preferred mode of delivery and the mode they suggest when being consulted by parturient.
Results
From 1,000 physicians, 785 cases (78.5%) responded to the survey. The rate of responses in favour of suggesting normal vaginal delivery, Caesarean Section and painless vaginal delivery was 60.8, 25.6 and 13.6%, respectively. There was a correlation between the suggested and the preferred mode of delivery, it means that the physicians mostly suggested their self-preferred mode of delivery to their patients.
Conclusions
Physicians normally suggest to their patients as the safe mode of delivery what they prefer for themselves. This preference and subsequent suggestion is influenced by different factors including their age, marital status, and previous modes of delivery. As conclusion, it is inferred that informing a physician to choose the right mode of delivery for herself leads to better suggestions to the patients.
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References
Husslein P, Wertaschnigg D (2002) Elective cesarean section-delivery mode of the future or social misconception? Ther Umsch 59(12):660–666. doi:10.1024/0040-5930.59.12.660
Mayor S (2002) Caesarean section rate in England reaches 22%. BMJ 324:1118. doi:10.1136/bmj.324.7346.1118
Centers for Disease Control and Prevention (1995) Rates of cesarean delivery—United States, 1993. MMWR Morb Mortal Wkly Rep 44:303–307
Australian Institute of Health and Welfare National Perinatal Statistics Unit. Australia’s mothers and babies, 2003. Available at: http://www.npsu.unsw.edu.au/Stats.htm.Retrieved October 27, 2006
Moini A, Riazi K, Ebrahimi A, Ostovan N (2007) Caesarean section rates in teaching hospitals of Tehran: 1999–2003. East Mediterr Health J 13(2):457–460
Rietberg CC, Elferink-Stinkens PM, Visser GH (2005) The effect of the Term Breech Trial on medical intervention behaviour and neonatal outcome in The Netherlands: an analysis of 35,453 term breech infants. BJOG 112:205–209. doi:10.1111/j.1471-0528.2004.00317.x
Dietz HP, Bennett MJ (2003) The effect of childbirth on pelvic organ mobility. Obstet Gynecol 102:223–228. doi:10.1016/S0029-7844(03)00476-9
Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S (2003) Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med 348:900–907. doi:10.1056/NEJMoa021788
Faridi A, Willis S, Schelzig P, Siggelkow W, Schumpelick V, Rath W (2002) Anal sphincter injury during vaginal delivery: an argument for cesarean section on request? J Perinat Med 30:379–387. doi:10.1515/JPM.2002.059
Wax JR, Cartin A, Pinette MG, Blackstone J (2004) Patient choice cesarean: an evidence-based review. Obstet Gynecol Surv 59:601–616. doi:10.1097/01.OGX.0000133942.76239.57
Kenton K, Brincat C, Mutone M, Brubaker L (2005) Repeat cesarean section and primary elective cesarean section: recently trained obstetrician-gynecologist practice patterns and opinions. Am J Obstet Gynecol 192:1872–1876. doi:10.1016/j.ajog.2005.01.046
Husslein P (2001) Elective caesarean section versus vaginal delivery. Whither the end of traditional obstetrics? Arch Gynecol Obstet 265(4):169–174
Al-Mufti R, McCarthy A, Fisk NM (1997) Obstetricians’ personal choice and mode of delivery. Lancet 349:544. doi:10.1016/S0140-6736(97)80096-7
Cotzias CS, Paterson-Brown S, Fisk NM (2001) Obstetricians say yes to maternal request for elective caesarean section: a survey of current opinion. Eur J Obstet Gynecol Reprod Biol 97:15–16. doi:10.1016/S0301-2115(00)00360-2
Gonen R, Tamir A, Degani S (2002) Obstetricians’ opinions regarding patient choice in cesarean delivery. Obstet Gynecol 999:577–580. doi:10.1016/S0029-7844(01)01766-5
Wright JB, Wright AL, Simpson NA, Bryce FC (2001) A survey of trainee obstetricians’ preferences for childbirth. Eur J Obstet Gynecol Reprod Biol 97:23–25. doi:10.1016/S0301-2115(01)00425-0
Acknowledgments
This study has been funded by Vali-e-asr Reproductive Health Research Centre affiliated to Tehran University of Medical Sciences. We hereby thank all staff of the research centre and all our colleagues in the Department of Gynaecology and Obstetrics. We are also grateful to Dr K. Shalileh for his cordial comments.
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The authors declare that they have no conflict of interest.
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Hantoushzadeh, S., Rajabzadeh, A., Saadati, A. et al. Caesarean or normal vaginal delivery: overview of physicians’ self-preference and suggestion to patients. Arch Gynecol Obstet 280, 33–37 (2009). https://doi.org/10.1007/s00404-008-0858-2
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DOI: https://doi.org/10.1007/s00404-008-0858-2