Obstetricians' and midwives' attitudes toward cesarean section.
BACKGROUND
The cesarean section rate has increased worldwide over the past 20 years; in Italy, it is now more than 35 percent. Although clinical factors are important, the attitudes of health practitioners toward cesarean section need further investigation to correctly identify facilitators and barriers to changes. The objective of this study was to explore the attitudes toward cesarean section of midwives and obstetricians who worked in the same geographical area.


METHODS
Face-to-face structured interviews using an adaptation of the Survey of Clinicians' Views on Caesarean Section, an anonymous questionnaire with 35 open and closed answers on practitioners' views on cesarean section, were conducted. The questionnaire was given to the entire group of midwives and obstetricians working in Modena, a northern Italian district.


RESULTS
Of 262 eligible practitioners, 248 were interviewed (response rate 94.6%). The midwives' attitudes toward cesarean section differed from those of the obstetricians. Sixty-five percent of midwives considered the rates of cesarean section in their hospitals to be too high compared with 34 percent of obstetricians (p < 0.001). Midwives were also less inclined to believe that cesarean section provides benefits to the mother (p = 0.02) or that it is indicated by previous cesarean delivery (p < 0.001). No differences were observed between male and female obstetricians.


CONCLUSIONS
In this survey, the attitudes toward cesarean section were correlated more with professional role than with gender. This information can help policy makers to shape interventions aimed at providing better care for pregnant and childbearing women.
Department of Obstetrics and Gynecology, University Hospital, Modena, Italy.
Francesca
F
Monari
Simona
S
Di Mario
Fabio
F
Facchinetti
Vittorio
V
Basevi
D000328:Adult; D001291:Attitude of Health Personnel; D002585:Cesarean Section / Q000523:psychology* / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007558:Italy; D008297:Male; D008880:Midwifery / Q000379:methods; D009721:Nurse Midwives / Q000523:psychology*; D009774:Obstetrics / Q000379:methods; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D017678:Sex Distribution; D011795:Surveys and Questionnaires