Ugo Indraccolo1, Gennaro Scutiero2, Maria Matteo3, Salvatore Renato Indraccolo4, Pantaleo Greco5. 1. Unità Operativa Complessa di Ginecologia e Ostetricia, Ospedale "Alto Tevere"di Città di Castello, ASL 1 Umbria, Città di Castello, Italy. 2. Unità Operativa Complessa di Ginecologia e Ostetricia, Ospedale Civico di Codogno, Azienda Ospedaliera della provincia di Lodi, Codogno, Italy. 3. Dipartimento di Scienze Cliniche e Chirurgiche, Università di Foggia, Foggia Italy. 4. Dipartimento di Scienze Ginecologiche, Ostetriche e Scienze Urologiche, Sapienza Università di Roma, Rome, Italy. 5. Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale, Università degli Studi di Ferrara, Ferrara, Italy
Abstract
BACKGROUND: Cesarean section on maternal request (CSMR) could represent an avoidable quota of cesareans. In Italy, this is a topical problem of health-policy, involving ethical, juridical and medical issues. AIM AND METHODS: A 5-questions questionnaire to quantitatively assess the perspectives of medical, juridical and ethical issues of planned CSMR was administered to obstetricians and gynecologists, midwives, lawyers and pregnant women. It was assessed to what extent those issues matter on the final decision of planning a CSMR. RESULTS: Non-homogeneous answers of stakeholders suggest different perspectives about issues on CSMR. The juridical issue seems to have the greatest impact on the final decision. CONCLUSION: Planning a CSMR associates overall with juridical issues in each group of respondents. Therefore, an obstetrician and gynecologist is unable to counsel a patient on CSMR from a medical point of view. The most direct way for reducing cesareans in Italy could be the formal prohibition of CSMR.
BACKGROUND: Cesarean section on maternal request (CSMR) could represent an avoidable quota of cesareans. In Italy, this is a topical problem of health-policy, involving ethical, juridical and medical issues. AIM AND METHODS: A 5-questions questionnaire to quantitatively assess the perspectives of medical, juridical and ethical issues of planned CSMR was administered to obstetricians and gynecologists, midwives, lawyers and pregnant women. It was assessed to what extent those issues matter on the final decision of planning a CSMR. RESULTS: Non-homogeneous answers of stakeholders suggest different perspectives about issues on CSMR. The juridical issue seems to have the greatest impact on the final decision. CONCLUSION: Planning a CSMR associates overall with juridical issues in each group of respondents. Therefore, an obstetrician and gynecologist is unable to counsel a patient on CSMR from a medical point of view. The most direct way for reducing cesareans in Italy could be the formal prohibition of CSMR.