Brazilian doctors' perspective on the second opinion strategy before a C-section.
OBJECTIVE
To describe the opinion of doctors who participated in the Latin American Study on Cesarean section in Brazil regarding the second opinion strategy when faced with the decision of performing a C-section.


METHODS
Seventy-two doctors from the hospitals where the study took place (where the second opinion was routinely sought) and 70 from the control group answered a pre-tested self-administered structured questionnaire. Descriptive tables were prepared based on the frequency of relevant variables on opinion of physicians regarding: effectiveness of the application of the second opinion strategy; on whether they would recommend implementation of this strategy and reasons for not recommending it in private institutions; feasibility of the strategy implementation and reasons for not considering this implementation feasible in private institutions.


RESULTS
Half of the doctors from the intervention hospitals (50%) and about two thirds of those in the control group (65%) evaluated the second opinion as being or having the potential of being effective/very effective in their institutions. The great majority of those interviewed from both intervention and control hospitals considered this strategy feasible in public (87% and 95% respectively) but not in private hospitals (64% and 70% respectively), mainly because in the latter the doctors would not accept interference from a colleague in their decision-making process.


CONCLUSIONS
Although the second opinion strategy was perceived as effective in reducing C-section rates, doctors did not regard it feasible outside the public health system in Brazil.
Osis
Maria José Duarte
MJ
Departamento de Obstetrícia e Ginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, 13081-970 Campinas, São Paulo, Brasil. mjosis@cemicamp.org.br
Cecatti
José Guilherme
JG
de Pádua
Karla Simônia
KS
Faúndes
Anibal
A
D000328:Adult; D001291:Attitude of Health Personnel; D001938:Brazil; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007843:Latin America; D008297:Male; D011247:Pregnancy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires