Department of Obstetrics and Gynaecology, Health Science University, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
Department of Perinatology, Medeniyet University, Istanbul, Turkey.
J Obstet Gynaecol. 2022 Aug;42(6):2033-2038. doi: 10.1080/01443615.2022.2080531. Epub 2022 Jun 6.
The aim of the study was to investigate the reasons for Turkish obstetricians having self-caesarean section on maternal request (CSMR) and their attitudes and practices related to CSMR and vaginal birth after caesarean section (VBAC). The questionnaire form constructed by the authors was sent online to obstetricians working in different cities of Turkey. A total of 206 obstetricians participated and answered a self-administered questionnaire. The self-birth preferences were as follows: 17% had a vaginal delivery (VD), 61.2% had a caesarean section (CS), 4.9% had both VD and CS. Of the participants with CS, 56.3% had CSMR. The most common reason for their having self-CSMR was that it was 'safe for the baby'. The most common reason for performing CSMR with their patients was 'due to birth anxiety and phobia'. Fifty-five percent of the participants said that they first recommended VD. The most common concern related to VBAC was 'I'm afraid of legal sanctions about complications'. Although many Turkish obstetricians recommend VD to their patients, they are afraid of the complaints/trials related to unforeseen complications during VD. IMPACT STATEMENT Caesarean section (CS) rates all over the world and in Turkey are rising. The exact frequency of CS on maternal request (CSMR) is not known, but it is estimated to be between 4% and 18%. Although Turkish obstetricians had high self-CSMR rates, they thought that it was more correct to direct patients to vaginal delivery (VD). Obstetricians are afraid of unforeseen complications during VD and related complaints and legal trials. Physicians expect improvements in the judgement and punishment issues related to unforeseen complications in the birth process. Besides the actual rates of CSMR need to be reported in the literature and why obstetricians perform CSMR needs to be investigated globally.
这项研究的目的是调查土耳其产科医生出于产妇要求（CSMR）而进行剖宫产的原因，以及他们对 CSMR 和剖宫产后阴道分娩（VBAC）的态度和做法。作者编制的问卷表通过网络发送给在土耳其不同城市工作的产科医生。共有 206 名产科医生参与并回答了一份自我管理的问卷。他们自己的分娩偏好如下：17%的人希望阴道分娩（VD），61.2%的人希望剖宫产（CS），4.9%的人希望两者都有。在进行 CS 的参与者中，56.3%的人进行了 CSMR。他们进行自我 CSMR 的最常见原因是“对婴儿安全”。他们为患者进行 CSMR 的最常见原因是“由于分娩焦虑和恐惧症”。55%的参与者表示他们首先推荐 VD。与 VBAC 相关的最常见问题是“我害怕并发症的法律制裁”。尽管许多土耳其产科医生向他们的患者推荐 VD，但他们害怕与 VD 期间不可预见的并发症相关的投诉/审判。
全世界和土耳其的剖宫产率都在上升。出于产妇要求的剖宫产（CSMR）的确切频率尚不清楚，但估计在 4%至 18%之间。尽管土耳其产科医生的自我 CSMR 率较高，但他们认为将患者引导至阴道分娩（VD）更为正确。产科医生害怕 VD 期间不可预见的并发症以及相关的投诉和法律审判。医生们希望改善与分娩过程中不可预见的并发症相关的判断和惩罚问题。此外，文献中需要报告实际的 CSMR 发生率，并且需要在全球范围内调查为什么产科医生要进行 CSMR。
