Cesarean delivery on maternal request: How do French obstetricians feel about it?

OBJECTIVE

The number of cesarean deliveries on maternal request (CDMR) is unknown in France. We aimed to evaluate the rate of obstetricians willing to perform a CDMR in 2020 in Paris and to compare OB/GYN seniors' and residents' points of view about CDMR using six hypothetical clinical scenarios.

STUDY DESIGN

A survey was conducted between January to March 2020 with an anonymous self-administrated questionnaire sent by email to OB/GYN seniors working in 16 public and private maternity units and residents of Paris. Questionnaire was based on previous peer-reviewed literature. Socio professional characteristics were collected. OB/GYN seniors were asked if they agree to perform a CDMR and have already done one. OB/GYN seniors' and residents' points of view on six hypothetical clinical scenarios (CDMR, scarred uterus, breech presentation, multiple pregnancy, history of perineal tears or stillbirth) were compared.

RESULTS

Eighty-three OB/GYN seniors and one hundred and fifteen residents answered to our questionnaire. Twenty-three (27,7%) OB/GYN seniors were ready to perform a CDMR, mostly because they think that mode of delivery is a woman's choice. Physicians working in a private maternity unit or having an exclusive private practice were significantly more willing to perform a cesarean delivery on maternal request. No differences were found between the OB/GYN seniors' and residents' point of view on the six hypothetical clinical scenarios. A third of OB/GYN seniors and residents reported having done at least one CDMR during their career or during their residency.

CONCLUSION

One out of four OB/GYN senior interviewed is ready to perform a CDMR in Paris in 2020. OB/GYN seniors and residents share the same point of view concerning CDMR.