Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study

Autores
Rivo, J. C.; Amyx, Melissa Michele; Pingray, María Verónica; Casale, R. A.; Fiorillo, Angel Eduardo; Krupitzki, Hugo Bernardo; Malamud, J. D.; Mendilaharzu, M.; Medina, M. L.; del Pino, A. B.; Ribola, L.; Schvartzman, Javier Alfonso; Tartalo, G. M.; Trasmonte, Monica; Varela, S.; Althabe, Fernando; Belizán, J. M.
Año de publicación
2018
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objective: To describe obstetrical providers’ delivery preferences and attitudes towards caesarean section without medical indication, including on maternal request, and to examine the association between provider characteristics and preferences/attitudes. Design: Cross-sectional study. Setting: Two public and two private hospitals in Argentina. Population: Obstetrician-gynaecologists and midwives who provide prenatal care and/or labour/delivery services. Methods: Providers in hospitals with at least 1000 births per year completed a self-administered, anonymous survey. Main outcome measures: Provider delivery preference for low-risk women, perception of women's preferred delivery method, support for a woman's right to choose her delivery method and willingness to perform caesarean section on maternal request. Results: 168 providers participated (89.8% coverage rate). Providers (93.2%) preferred a vaginal delivery for their patients in the absence of a medical indication for caesarean section. Whereas 74.4% of providers supported their patient's right to choose a delivery method in the absence of a medical indication for caesarean section and 66.7% would perform a caesarean section upon maternal request, only 30.4% would consider a non-medically indicated caesarean section for their own personal delivery or that of their partner. In multivariate adjusted analysis, providers in the private sector [odds ratio (OR) 4.70, 95% CI 1.19–18.62] and obstetrician-gynaecologists (OR 4.37, 95% CI 1.58–12.09) were more willing than either providers working in the public/both settings or midwives to perform a caesarean section on maternal request. Conclusions: Despite the ethical debate surrounding non-medically indicated caesarean sections, we observe very high levels of support, especially by providers in the private sector and obstetrician-gynaecologists, as aligned with the high caesarean section rates in Argentina. Tweetable abstract: Non-medically indicated c-section? 74% of sampled Argentine OB providers support women's right to choose.
Fil: Rivo, J. C.. Duke University Medical Center; Estados Unidos
Fil: Amyx, Melissa Michele. University of Tulane; Estados Unidos. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Pingray, María Verónica. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Casale, R. A.. Hospital Nacional Profesor Dr. Alejandro Posadas; Argentina
Fil: Fiorillo, Angel Eduardo. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; Argentina
Fil: Krupitzki, Hugo Bernardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Malamud, J. D.. Sanatorio de la Mujer; Argentina
Fil: Mendilaharzu, M.. Instituto de Maternidad y Ginecología Nuestra Señora de Las Mercedes; Argentina
Fil: Medina, M. L.. Instituto de Maternidad y Ginecología Nuestra Señora de Las Mercedes; Argentina
Fil: del Pino, A. B.. Sanatorio de la Mujer; Argentina
Fil: Ribola, L.. Hospital Nacional Professor Dr. Alejandro Posadas; Argentina
Fil: Schvartzman, Javier Alfonso. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Tartalo, G. M.. Instituto de Maternidad y Ginecología Nuestra Señora de Las Mercedes; Argentina
Fil: Trasmonte, Monica. Hospital Nacional Profesor Dr. Alejandro Posadas; Argentina
Fil: Varela, S.. Hospital Nacional Profesor Dr. Alejandro Posadas; Argentina
Fil: Althabe, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Belizán, J. M.. Instituto de Efectividad Clínica y Sanitaria; Argentina
Materia
CAESAREAN SECTION
CESAREAN SECTION/EPIDEMIOLOGY
CESAREAN SECTION/UTILISATION
MATERNAL REQUEST
NON-MEDICALLY INDICATED CAESAREAN SECTION
OBSTETRICIANS’ ATTITUDE
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/97743
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/97743
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repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional studyRivo, J. C.Amyx, Melissa MichelePingray, María VerónicaCasale, R. A.Fiorillo, Angel EduardoKrupitzki, Hugo BernardoMalamud, J. D.Mendilaharzu, M.Medina, M. L.del Pino, A. B.Ribola, L.Schvartzman, Javier AlfonsoTartalo, G. M.Trasmonte, MonicaVarela, S.Althabe, FernandoBelizán, J. M.CAESAREAN SECTIONCESAREAN SECTION/EPIDEMIOLOGYCESAREAN SECTION/UTILISATIONMATERNAL REQUESTNON-MEDICALLY INDICATED CAESAREAN SECTIONOBSTETRICIANS’ ATTITUDEhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Objective: To describe obstetrical providers’ delivery preferences and attitudes towards caesarean section without medical indication, including on maternal request, and to examine the association between provider characteristics and preferences/attitudes. Design: Cross-sectional study. Setting: Two public and two private hospitals in Argentina. Population: Obstetrician-gynaecologists and midwives who provide prenatal care and/or labour/delivery services. Methods: Providers in hospitals with at least 1000 births per year completed a self-administered, anonymous survey. Main outcome measures: Provider delivery preference for low-risk women, perception of women's preferred delivery method, support for a woman's right to choose her delivery method and willingness to perform caesarean section on maternal request. Results: 168 providers participated (89.8% coverage rate). Providers (93.2%) preferred a vaginal delivery for their patients in the absence of a medical indication for caesarean section. Whereas 74.4% of providers supported their patient's right to choose a delivery method in the absence of a medical indication for caesarean section and 66.7% would perform a caesarean section upon maternal request, only 30.4% would consider a non-medically indicated caesarean section for their own personal delivery or that of their partner. In multivariate adjusted analysis, providers in the private sector [odds ratio (OR) 4.70, 95% CI 1.19–18.62] and obstetrician-gynaecologists (OR 4.37, 95% CI 1.58–12.09) were more willing than either providers working in the public/both settings or midwives to perform a caesarean section on maternal request. Conclusions: Despite the ethical debate surrounding non-medically indicated caesarean sections, we observe very high levels of support, especially by providers in the private sector and obstetrician-gynaecologists, as aligned with the high caesarean section rates in Argentina. Tweetable abstract: Non-medically indicated c-section? 74% of sampled Argentine OB providers support women's right to choose.Fil: Rivo, J. C.. Duke University Medical Center; Estados UnidosFil: Amyx, Melissa Michele. University of Tulane; Estados Unidos. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Pingray, María Verónica. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Casale, R. A.. Hospital Nacional Profesor Dr. Alejandro Posadas; ArgentinaFil: Fiorillo, Angel Eduardo. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; ArgentinaFil: Krupitzki, Hugo Bernardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Malamud, J. D.. Sanatorio de la Mujer; ArgentinaFil: Mendilaharzu, M.. Instituto de Maternidad y Ginecología Nuestra Señora de Las Mercedes; ArgentinaFil: Medina, M. L.. Instituto de Maternidad y Ginecología Nuestra Señora de Las Mercedes; ArgentinaFil: del Pino, A. B.. Sanatorio de la Mujer; ArgentinaFil: Ribola, L.. Hospital Nacional Professor Dr. Alejandro Posadas; ArgentinaFil: Schvartzman, Javier Alfonso. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Tartalo, G. M.. Instituto de Maternidad y Ginecología Nuestra Señora de Las Mercedes; ArgentinaFil: Trasmonte, Monica. Hospital Nacional Profesor Dr. Alejandro Posadas; ArgentinaFil: Varela, S.. Hospital Nacional Profesor Dr. Alejandro Posadas; ArgentinaFil: Althabe, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Belizán, J. M.. Instituto de Efectividad Clínica y Sanitaria; ArgentinaWiley Blackwell Publishing, Inc2018-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/97743Rivo, J. C.; Amyx, Melissa Michele; Pingray, María Verónica; Casale, R. A.; Fiorillo, Angel Eduardo; et al.; Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study; Wiley Blackwell Publishing, Inc; BJOG - An International Journal of Obstetrics and Gynaecology; 125; 10; 9-2018; 1294-13021470-0328CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/http://doi.wiley.com/10.1111/1471-0528.15122info:eu-repo/semantics/altIdentifier/doi/10.1111/1471-0528.15122info:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041183/info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:40:42Zoai:ri.conicet.gov.ar:11336/97743instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:40:42.867CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study
title Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study
spellingShingle Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study
Rivo, J. C.
CAESAREAN SECTION
CESAREAN SECTION/EPIDEMIOLOGY
CESAREAN SECTION/UTILISATION
MATERNAL REQUEST
NON-MEDICALLY INDICATED CAESAREAN SECTION
OBSTETRICIANS’ ATTITUDE
title_short Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study
title_full Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study
title_fullStr Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study
title_full_unstemmed Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study
title_sort Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study
dc.creator.none.fl_str_mv Rivo, J. C.
Amyx, Melissa Michele
Pingray, María Verónica
Casale, R. A.
Fiorillo, Angel Eduardo
Krupitzki, Hugo Bernardo
Malamud, J. D.
Mendilaharzu, M.
Medina, M. L.
del Pino, A. B.
Ribola, L.
Schvartzman, Javier Alfonso
Tartalo, G. M.
Trasmonte, Monica
Varela, S.
Althabe, Fernando
Belizán, J. M.
author Rivo, J. C.
author_facet Rivo, J. C.
Amyx, Melissa Michele
Pingray, María Verónica
Casale, R. A.
Fiorillo, Angel Eduardo
Krupitzki, Hugo Bernardo
Malamud, J. D.
Mendilaharzu, M.
Medina, M. L.
del Pino, A. B.
Ribola, L.
Schvartzman, Javier Alfonso
Tartalo, G. M.
Trasmonte, Monica
Varela, S.
Althabe, Fernando
Belizán, J. M.
author_role author
author2 Amyx, Melissa Michele
Pingray, María Verónica
Casale, R. A.
Fiorillo, Angel Eduardo
Krupitzki, Hugo Bernardo
Malamud, J. D.
Mendilaharzu, M.
Medina, M. L.
del Pino, A. B.
Ribola, L.
Schvartzman, Javier Alfonso
Tartalo, G. M.
Trasmonte, Monica
Varela, S.
Althabe, Fernando
Belizán, J. M.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv CAESAREAN SECTION
CESAREAN SECTION/EPIDEMIOLOGY
CESAREAN SECTION/UTILISATION
MATERNAL REQUEST
NON-MEDICALLY INDICATED CAESAREAN SECTION
OBSTETRICIANS’ ATTITUDE
topic CAESAREAN SECTION
CESAREAN SECTION/EPIDEMIOLOGY
CESAREAN SECTION/UTILISATION
MATERNAL REQUEST
NON-MEDICALLY INDICATED CAESAREAN SECTION
OBSTETRICIANS’ ATTITUDE
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objective: To describe obstetrical providers’ delivery preferences and attitudes towards caesarean section without medical indication, including on maternal request, and to examine the association between provider characteristics and preferences/attitudes. Design: Cross-sectional study. Setting: Two public and two private hospitals in Argentina. Population: Obstetrician-gynaecologists and midwives who provide prenatal care and/or labour/delivery services. Methods: Providers in hospitals with at least 1000 births per year completed a self-administered, anonymous survey. Main outcome measures: Provider delivery preference for low-risk women, perception of women's preferred delivery method, support for a woman's right to choose her delivery method and willingness to perform caesarean section on maternal request. Results: 168 providers participated (89.8% coverage rate). Providers (93.2%) preferred a vaginal delivery for their patients in the absence of a medical indication for caesarean section. Whereas 74.4% of providers supported their patient's right to choose a delivery method in the absence of a medical indication for caesarean section and 66.7% would perform a caesarean section upon maternal request, only 30.4% would consider a non-medically indicated caesarean section for their own personal delivery or that of their partner. In multivariate adjusted analysis, providers in the private sector [odds ratio (OR) 4.70, 95% CI 1.19–18.62] and obstetrician-gynaecologists (OR 4.37, 95% CI 1.58–12.09) were more willing than either providers working in the public/both settings or midwives to perform a caesarean section on maternal request. Conclusions: Despite the ethical debate surrounding non-medically indicated caesarean sections, we observe very high levels of support, especially by providers in the private sector and obstetrician-gynaecologists, as aligned with the high caesarean section rates in Argentina. Tweetable abstract: Non-medically indicated c-section? 74% of sampled Argentine OB providers support women's right to choose.
Fil: Rivo, J. C.. Duke University Medical Center; Estados Unidos
Fil: Amyx, Melissa Michele. University of Tulane; Estados Unidos. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Pingray, María Verónica. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Casale, R. A.. Hospital Nacional Profesor Dr. Alejandro Posadas; Argentina
Fil: Fiorillo, Angel Eduardo. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; Argentina
Fil: Krupitzki, Hugo Bernardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Malamud, J. D.. Sanatorio de la Mujer; Argentina
Fil: Mendilaharzu, M.. Instituto de Maternidad y Ginecología Nuestra Señora de Las Mercedes; Argentina
Fil: Medina, M. L.. Instituto de Maternidad y Ginecología Nuestra Señora de Las Mercedes; Argentina
Fil: del Pino, A. B.. Sanatorio de la Mujer; Argentina
Fil: Ribola, L.. Hospital Nacional Professor Dr. Alejandro Posadas; Argentina
Fil: Schvartzman, Javier Alfonso. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Tartalo, G. M.. Instituto de Maternidad y Ginecología Nuestra Señora de Las Mercedes; Argentina
Fil: Trasmonte, Monica. Hospital Nacional Profesor Dr. Alejandro Posadas; Argentina
Fil: Varela, S.. Hospital Nacional Profesor Dr. Alejandro Posadas; Argentina
Fil: Althabe, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Belizán, J. M.. Instituto de Efectividad Clínica y Sanitaria; Argentina
description Objective: To describe obstetrical providers’ delivery preferences and attitudes towards caesarean section without medical indication, including on maternal request, and to examine the association between provider characteristics and preferences/attitudes. Design: Cross-sectional study. Setting: Two public and two private hospitals in Argentina. Population: Obstetrician-gynaecologists and midwives who provide prenatal care and/or labour/delivery services. Methods: Providers in hospitals with at least 1000 births per year completed a self-administered, anonymous survey. Main outcome measures: Provider delivery preference for low-risk women, perception of women's preferred delivery method, support for a woman's right to choose her delivery method and willingness to perform caesarean section on maternal request. Results: 168 providers participated (89.8% coverage rate). Providers (93.2%) preferred a vaginal delivery for their patients in the absence of a medical indication for caesarean section. Whereas 74.4% of providers supported their patient's right to choose a delivery method in the absence of a medical indication for caesarean section and 66.7% would perform a caesarean section upon maternal request, only 30.4% would consider a non-medically indicated caesarean section for their own personal delivery or that of their partner. In multivariate adjusted analysis, providers in the private sector [odds ratio (OR) 4.70, 95% CI 1.19–18.62] and obstetrician-gynaecologists (OR 4.37, 95% CI 1.58–12.09) were more willing than either providers working in the public/both settings or midwives to perform a caesarean section on maternal request. Conclusions: Despite the ethical debate surrounding non-medically indicated caesarean sections, we observe very high levels of support, especially by providers in the private sector and obstetrician-gynaecologists, as aligned with the high caesarean section rates in Argentina. Tweetable abstract: Non-medically indicated c-section? 74% of sampled Argentine OB providers support women's right to choose.
publishDate 2018
dc.date.none.fl_str_mv 2018-09
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/97743
Rivo, J. C.; Amyx, Melissa Michele; Pingray, María Verónica; Casale, R. A.; Fiorillo, Angel Eduardo; et al.; Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study; Wiley Blackwell Publishing, Inc; BJOG - An International Journal of Obstetrics and Gynaecology; 125; 10; 9-2018; 1294-1302
1470-0328
CONICET Digital
CONICET
url http://hdl.handle.net/11336/97743
identifier_str_mv Rivo, J. C.; Amyx, Melissa Michele; Pingray, María Verónica; Casale, R. A.; Fiorillo, Angel Eduardo; et al.; Obstetrical providers’ preferred mode of delivery and attitude towards non-medically indicated caesarean sections: a cross-sectional study; Wiley Blackwell Publishing, Inc; BJOG - An International Journal of Obstetrics and Gynaecology; 125; 10; 9-2018; 1294-1302
1470-0328
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://doi.wiley.com/10.1111/1471-0528.15122
info:eu-repo/semantics/altIdentifier/doi/10.1111/1471-0528.15122
info:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041183/
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
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instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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