Differences among obstetricians in caesarean section rates.

This retrospective study examined the Caesarean section rates of 15 obstetricians at 1 hospital delivering 5,559 nulliparas with a single cephalic baby of birth-weight > or = 2,500 g. There was a wide variation in obstetricians' Caesarean rates, whether considering all their deliveries (5.5% to 20.1%), deliveries of their own patients (8.9% to 28.2%), or deliveries of their colleagues' patients (4.5% to 17.9%). There was no relation between Caesarean rates and perinatal outcome. The different Caesarean section rates among the obstetricians could not be explained by institutional factors, physician convenience, patient differences, or self-serving economic incentives.