Finsen Vilhjalmur, Storeheier Andreas Hopstock, Aasland Olaf Gjerløw
Department of Orthopaedic Surgery, St. Olav's University Hospital, and Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
Birth. 2008 Jun;35(2):117-20. doi: 10.1111/j.1523-536X.2008.00224.x.
The worrying trend of an ever-increasing incidence of delivery by cesarean section has been commented on repeatedly. Studies from the United Kingdom and the United States have found that many obstetricians would choose cesarean section for themselves without strict medical indication, whereas similar studies from Denmark and Norway have indicated that almost none would choose cesarean section for themselves. The purpose of this study was to report the proportion of Norwegian obstetricians who have children born by cesarean section and to compare the rate with that among other physicians and that with the general population.
Questionnaires were sent to 1,500 random members of the Norwegian general public, 1,500 randomly selected physicians, and 423 random surgeons asking whether they had children born by cesarean section. All were between the ages of 40 and 65 years.
The response rate was 78 percent. In the general public with children, 12 percent reported that one or more of them were born by cesarean section. The average was 8 percent among those with only basic schooling compared with 16 percent (p < 0.02) among those who had been to university for more than 4 years. This figure was 19 percent among physicians in general (p < 0.001 compared with the general population), 26 percent among surgeons, and 27 percent among the 189 specialists in obstetrics and gynecology (p < 0.02 compared with the physicians in general).
The rate of cesarean section in the general population is unlikely to fall as long as so many obstetricians have their own children delivered by cesarean section.
剖宫产分娩发生率不断上升这一令人担忧的趋势已被多次提及。英国和美国的研究发现，许多产科医生在没有严格医学指征的情况下会为自己选择剖宫产，而丹麦和挪威的类似研究表明几乎没有人会为自己选择剖宫产。本研究的目的是报告挪威产科医生中其孩子为剖宫产出生的比例，并将该比例与其他医生以及普通人群的比例进行比较。
向1500名挪威普通公众、1500名随机抽取的医生以及423名随机抽取的外科医生发放问卷，询问他们是否有孩子为剖宫产出生。所有受访者年龄均在40至65岁之间。
回复率为78%。在有孩子的普通公众中，12%报告其一个或多个孩子为剖宫产出生。只有基础教育学历的人群中这一比例平均为8%，而接受过4年以上大学教育的人群中该比例为16%（p<0.02）。一般医生中这一比例为19%（与普通人群相比p<0.001），外科医生中为26%，189名妇产科专科医生中为27%（与一般医生相比p<0.02）。
只要有如此多的产科医生让自己的孩子通过剖宫产出生，普通人群中的剖宫产率就不太可能下降。
