Original research
Obstetricians’ opinions regarding patient choice in cesarean delivery

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Abstract

OBJECTIVE:

To survey the opinions of Israeli obstetricians regarding their position on patient choice cesarean delivery.

METHODS:

Short anonymous questionnaires were sent by mail. The questionnaire included basic demographic data followed by three short case presentations of patients requesting cesarean delivery without a medical indication; the respondents were asked if they would consent to the patients’ request. Respondents were then asked about their personal preferences on the mode of delivery, their attitude towards women’s right to choose cesarean delivery, and whether obstetricians should inform their patients of this right.

RESULTS:

Of the 650 questionnaires sent, 257 were returned. Most of the respondents were specialists, aged 35 years or older, and worked in hospitals. Seventy-five percent were male, and 27% had a teaching academic degree. The consent rate for patient choice cesarean delivery in the three case presentations ranged from 40% to 79%. Only 9% of the respondents said they would prefer cesarean delivery for themselves (if female) or for their partners. Forty-five percent supported women’s right to choose cesarean delivery, and half of them stated that obstetricians should inform their patients of this right.

CONCLUSION:

Although the vast majority (91%) of the Israeli respondents personally prefer vaginal delivery, almost half of them support women’s autonomy to choose cesarean delivery. Consequently, approximately 50% of the respondents were willing to perform cesarean delivery on request because of their support of women’s autonomy, despite the fact that they believe that vaginal delivery is a better option.

Section snippets

Materials and methods

The survey was strictly anonymous. A questionnaire was sent by mail to 650 Israeli obstetricians (approximately 60% of the obstetricians in Israel) who were on a mailing list as participants in national monthly meetings of obstetricians. A total of 270 questionnaires were answered. No follow-up questionnaires were sent to obstetricians who did not return the questionnaire, and their demographic data were not investigated. However, the demographic profile of the respondents, as presented in

Results

The demographic data of the 257 respondents is shown in Table 1. The number and percentage of obstetricians who consented to perform cesarean in the three cases presented in the questionnaire are shown in Table 2. The respondents’ consent rate ranged from 40% to 79% according to the clinical situation. Eighty-eight respondents (34%, 95% CI 28, 40) agreed to perform cesarean in all three clinical situations, 121 (47%, 95% CI 41, 53) consented in one or two clinical situations, and 48 (19%, 95%

Discussion

Approximately half of the respondents to this survey—of whom 81% were certified obstetricians, 73% working in hospitals and 26% with a teaching academic degree— consented to patient choice cesarean. The rate of consent ranged from 80% in the case of a 40-year-old primigravida to 41% in the case of a primigravida with no known risk factors. Almost half of the respondents supported the principle that women should have the right to choose cesarean as the mode of delivery if they wish so. Moreover,

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