OBJECTIVE: To survey the personal preferences of obstetricians regarding mode of delivery, and relate these to hospital caesarean section rates. STUDY DESIGN: A confidential, questionnaire based survey to all obstetricians working in the Republic of Ireland (n=234). RESULTS: The response rate was 71% (n=165). Seven percent of Irish obstetricians would choose an elective caesarean section for themselves (or their partners) if they were primigravida with an uncomplicated, singleton cephalic presentation at term in the absence of any clinical indication. Caesarean section was the preferred mode of delivery for 38% of respondents if the estimated foetal weight was 4.5kg. There was a highly significant association between consultant obstetricians' personal preferences of towards caesarean section and their working in a hospital with a caesarean section rate greater than 16% (P<0.005). CONCLUSIONS: Irish obstetricians' personal preferences towards elective caesarean section for an uncomplicated, cephalic pregnancy at term are significantly lower than published data examining London based obstetricians' choices. There is a consistent trend against vaginal delivery if the obstetrician is female or younger. The association between a personal preference of the consultant for abdominal delivery and the caesarean section rate of the hospital that they work in may hamper efforts to decrease the rising numbers of caesarean sections.
OBJECTIVE: To survey the personal preferences of obstetricians regarding mode of delivery, and relate these to hospital caesarean section rates. STUDY DESIGN: A confidential, questionnaire based survey to all obstetricians working in the Republic of Ireland (n=234). RESULTS: The response rate was 71% (n=165). Seven percent of Irish obstetricians would choose an elective caesarean section for themselves (or their partners) if they were primigravida with an uncomplicated, singleton cephalic presentation at term in the absence of any clinical indication. Caesarean section was the preferred mode of delivery for 38% of respondents if the estimated foetal weight was 4.5kg. There was a highly significant association between consultant obstetricians' personal preferences of towards caesarean section and their working in a hospital with a caesarean section rate greater than 16% (P<0.005). CONCLUSIONS: Irish obstetricians' personal preferences towards elective caesarean section for an uncomplicated, cephalic pregnancy at term are significantly lower than published data examining London based obstetricians' choices. There is a consistent trend against vaginal delivery if the obstetrician is female or younger. The association between a personal preference of the consultant for abdominal delivery and the caesarean section rate of the hospital that they work in may hamper efforts to decrease the rising numbers of caesarean sections.