OBJECTIVE: The purpose of the study was to investigate the incidence of intrapartum patient choice cesarean delivery-patients' requesting cesarean delivery and physicians' offering it during labor-and factors possibly influencing these requests and offers. METHODS: For a 6-month period from May 1, 2002, to October 31, 2002, obstetricians were asked to complete a questionnaire after all intrapartum cesarean deliveries regarding whether cesarean delivery was offered by the obstetrician or requested by the patient before being medically indicated. Patient medical records and physician demographic information were reviewed. RESULTS: There were 422 cases that met inclusion criteria. Questionnaires were completed in 100% of cases. Cesarean delivery was offered in 13% before a clear medical indication and requested in 8.8%. Older obstetricians, maternal-fetal medicine specialists, and full-time faculty were significantly more likely to offer cesarean delivery (P =.009, P <.001, and P =.015, respectively). Patients who were unmarried or undergoing labor induction were less likely to request cesarean delivery (P =.029 and P =.035, respectively). Maternal age, parity, stage or length of labor, epidural use, gestational age, insurance status, day of week, and time of delivery did not affect whether patients requested or were offered cesarean delivery. CONCLUSION: This study documents a heretofore unrecognized clinical entity: intrapartum elective cesarean delivery. Physician characteristics, as opposed to patient characteristics or intrapartum factors, are a major determinant of whether laboring patients are being offered cesarean delivery. LEVEL OF EVIDENCE: III
OBJECTIVE: The purpose of the study was to investigate the incidence of intrapartum patient choice cesarean delivery-patients' requesting cesarean delivery and physicians' offering it during labor-and factors possibly influencing these requests and offers. METHODS: For a 6-month period from May 1, 2002, to October 31, 2002, obstetricians were asked to complete a questionnaire after all intrapartum cesarean deliveries regarding whether cesarean delivery was offered by the obstetrician or requested by the patient before being medically indicated. Patient medical records and physician demographic information were reviewed. RESULTS: There were 422 cases that met inclusion criteria. Questionnaires were completed in 100% of cases. Cesarean delivery was offered in 13% before a clear medical indication and requested in 8.8%. Older obstetricians, maternal-fetal medicine specialists, and full-time faculty were significantly more likely to offer cesarean delivery (P =.009, P <.001, and P =.015, respectively). Patients who were unmarried or undergoing labor induction were less likely to request cesarean delivery (P =.029 and P =.035, respectively). Maternal age, parity, stage or length of labor, epidural use, gestational age, insurance status, day of week, and time of delivery did not affect whether patients requested or were offered cesarean delivery. CONCLUSION: This study documents a heretofore unrecognized clinical entity: intrapartum elective cesarean delivery. Physician characteristics, as opposed to patient characteristics or intrapartum factors, are a major determinant of whether laboring patients are being offered cesarean delivery. LEVEL OF EVIDENCE: III
Authors: Jun Zhang; James Troendle; Uma M Reddy; S Katherine Laughon; D Ware Branch; Ronald Burkman; Helain J Landy; Judith U Hibbard; Shoshana Haberman; Mildred M Ramirez; Jennifer L Bailit; Matthew K Hoffman; Kimberly D Gregory; Victor H Gonzalez-Quintero; Michelle Kominiarek; Lee A Learman; Christos G Hatjis; Paul van Veldhuisen Journal: Am J Obstet Gynecol Date: 2010-08-12 Impact factor: 8.661
Authors: Whitney P Witt; Lauren E Wisk; Erika R Cheng; Kara Mandell; Debanjana Chatterjee; Fathima Wakeel; Amy L Godecker; Dakota Zarak Journal: Matern Child Health J Date: 2015-01
Authors: José Villar; Guillermo Carroli; Nelly Zavaleta; Allan Donner; Daniel Wojdyla; Anibal Faundes; Alejandro Velazco; Vicente Bataglia; Ana Langer; Alberto Narváez; Eliette Valladares; Archana Shah; Liana Campodónico; Mariana Romero; Sofia Reynoso; Karla Simônia de Pádua; Daniel Giordano; Marius Kublickas; Arnaldo Acosta Journal: BMJ Date: 2007-10-30
Authors: Maria Regina Torloni; Silvia Daher; Ana Pilar Betrán; Mariana Widmer; Pilar Montilla; Joao Paulo Souza; Mario Merialdi Journal: BMJ Date: 2011-01-25
Authors: Maria do Carmo Leal; Antônio Augusto Moura da Silva; Marcos Augusto Bastos Dias; Silvana Granado Nogueira da Gama; Daphne Rattner; Maria Elizabeth Moreira; Mariza Miranda Theme Filha; Rosa Maria Soares Madeira Domingues; Ana Paula Esteves Pereira; Jacqueline Alves Torres; Sonia Duarte Azevedo Bittencourt; Eleonora D'orsi; Antonio Jla Cunha; Alvaro Jorge Madeiro Leite; Rejane Silva Cavalcante; Sonia Lansky; Carmem Simone Grilo Diniz; Célia Landmann Szwarcwald Journal: Reprod Health Date: 2012-08-22 Impact factor: 3.223