Repeat cesarean section and primary elective cesarean section: recently trained obstetrician-gynecologist practice patterns and opinions.
OBJECTIVE
This study was undertaken to determine opinions of obstetrician-gynecologists regarding vaginal birth after cesarean (VBAC) section and elective cesarean section.


METHODS
A questionnaire was administered to obstetrician-gynecologists attending 2 review courses.


RESULTS
Of 500 obstetrician-gynecologists, 304 completed the survey for a response rate of 61%. Most (92%) counseled VBAC candidates differently, and 84% quoted differential VBAC completion rates on the basis of the indication for prior cesarean section. Uterine rupture was virtually always discussed (99%). Pelvic floor risks were infrequently discussed with urinary incontinence, pelvic organ prolapse, and fecal incontinence discussed by less than one third of obstetricians (30%, 28%, and 25%, respectively). Fifty-nine percent of physicians would perform a primary elective cesarean section, and 67% would perform a primary elective cesarean section specifically to prevent pelvic floor disorders.


CONCLUSIONS
Two thirds of recent graduates are willing to perform an elective cesarean section to prevent pelvic floor injury. Most offer VBAC; however, less than a third include risk of pelvic floor injury in their informed consent discussions.
Kenton
Kimberly
K
Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University Medical Center, Maywood, IL 60153, USA. kkenton@lumc.edu
Brincat
Cynthia
C
Mutone
Martina
M
Brubaker
Linda
L
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D017604:Cesarean Section, Repeat / Q000706:statistics & numerical data; D004502:Education, Medical, Continuing; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D005242:Fecal Incontinence / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics / Q000193:education; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014550:Urinary Incontinence, Stress / Q000517:prevention & control; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data