Ghetti Chiara, Chan Benjamin K S, Guise Jeanne-Marie
Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, 97239-3098, USA.
Birth. 2004 Dec;31(4):280-4. doi: 10.1111/j.0730-7659.2004.00320.x.
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.
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.
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.
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.
关于女性分娩自主权是否应包括在无医学指征情况下选择剖宫产这一问题，已成为主要的争议来源。我们的目的是研究决定医生对患者要求剖宫产的反应的因素。
2000年春季，向俄勒冈州波特兰市大都市区的所有妇产科医生发放了调查问卷。要求医生对涉及一名足月单胎妊娠患者要求首次剖宫产的情景做出回应。
255名医生中有170名（67%）做出了回应，其中68%至98%的医生在有明确医学指征的情况下同意剖宫产。在没有明确医学指征的情况下，大多数从业者不会进行剖宫产。在医学指征不明确的情况下，回应存在分歧。医生为男性以及患者社会经济地位高与医生同意患者要求剖宫产的可能性增加有关。年龄、从业年限和执业类型与同意与否无关。
医生不愿在没有明确医学指征的情况下同意患者要求首次剖宫产。男性医生比女性医生更有可能同意患者的剖宫产要求。
