Physicians' responses to patient-requested cesarean delivery.
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.
Ghetti
Chiara
C
Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, 97239-3098, USA.
Chan
Benjamin K S
BK
Guise
Jeanne-Marie
JM
D000328:Adult; D000368:Aged; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics; D009922:Oregon / Q000453:epidemiology; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014504:Urban Health