Chiara Ghetti is at the Department of Obstetrics and Gynecology, Oregon Health & Science University; Benjamin Chan is at the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University Evidence-based Practice Center; and Jeanne-Marie Guise is at the Department of Obstetrics and Gynecology and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University Evidence-based Practice Center, Portland, Oregon, United States.
Physicians’ Responses to Patient-Requested Cesarean Delivery
Version of Record online: 25 NOV 2004
Volume 31, Issue 4, pages 280–284, December 2004
How to Cite
Ghetti, C., Chan, B. K.S. and Guise, J.-M. (2004), Physicians’ Responses to Patient-Requested Cesarean Delivery. Birth, 31: 280–284. doi: 10.1111/j.0730-7659.2004.00320.x
This research was supported by grant 1 K08 HS11338-01 from the Agency for Healthcare Research and Quality, United States Department of Health and Human Services, Rockville, Maryland, USA.
- Issue online: 25 NOV 2004
- Version of Record online: 25 NOV 2004
Abstract: Background: The issue about whether a woman's autonomy in childbirth should include the choice of cesarean delivery in the absence of medical indications has become a major source of debate. Our objective was to examine factors that determined physicians’ responses to patient-requested cesarean delivery. Methods: Surveys were distributed to all obstetrician-gynecologists in the greater Portland, Oregon, metropolitan area in Spring, 2000. Physicians were asked to respond to scenarios involving a term patient with a singleton pregnancy requesting primary cesarean delivery. Results: One hundred and seventy of 255 physicians (67%) responded, of whom 68 to 98 percent agreed to cesarean delivery in cases with clear medical indications. Without a clear medical indication, most practitioners would not perform a cesarean delivery. In cases where medical indications were unclear, responses were divided. Physician male gender and patient high socioeconomic status were associated with increased likelihood of physician agreement to patient-requested cesarean delivery. Age, years in practice, and practice type were not associated with agreement. Conclusions: Physicians are reluctant to agree to patient request for primary cesarean delivery without a clear medical indication. Male physicians were more likely to agree to a patient's request for cesarean delivery than female physicians.