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Obstetricians’ Opinions Regarding Patient Choice in Cesarean Delivery

From the Department of Obstetrics and Gynecology, Bnai Zion Medical Center, Haifa, Israel, and Department of Community Medicine, Faculty of Medicine, Technion, Haifa, Israel.

Address reprint requests to: R. Gonen, MD, Bnai Zion Medical Center, Department of Obstetrics and Gynecology, 47 Golomb Street, Haifa, Israel; E-mail: rliat{at}macam.ac.il.

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.

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