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Elective Primary Cesarean Delivery: Attitudes of Urogynecology and Maternal-Fetal Medicine Specialists

From the Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, North Carolina.

OBJECTIVE: To compare the attitudes of urogynecology and maternal–fetal medicine specialists in the United States regarding elective primary cesarean delivery.

METHODS: A Web-based questionnaire was sent by e-mail to members of the American Urogynecologic Society (AUGS) and the Society for Maternal–Fetal Medicine (SMFM) who reside in the United States. The first e-mail was sent in October 2003, and 2 additional e-mails were sent to nonresponders over the next month. The survey included questions about demographics, practice patterns, and opinions about different clinical scenarios regarding elective primary cesarean delivery.

RESULTS: Of 1,479 surveys sent to functioning e-mail addresses, 782 were completed (52.9% response rate). American Urogynecologic Society and Society for Maternal–Fetal Medicine members were similar in response rate (53.0% versus 52.8%, respectively). Overall, 65.4% of physicians would perform an elective cesarean delivery, but AUGS members were significantly more likely to agree to perform an elective cesarean than SMFM members (80.4% versus 55.4%, respectively, P < .001). In a logistic regression model that included age, sex, having no children, years in practice, and subspecialty (urogynecology or maternal–fetal medicine), AUGS members were 3.4 times (95% confidence interval 2.3–4.9, P < .001) more likely to agree to perform an elective cesarean.

CONCLUSION: Among respondents, a majority of urogynecology and maternal–fetal medicine specialists surveyed would perform an elective primary cesarean delivery. Urogynecologists were significantly more likely to support elective cesareans.

LEVEL OF EVIDENCE: II-3

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