Communication and decision-making of cesarean sections in China: an exploration of both obstetricians’ and patients’ perspectives

Abstract

ABSTRACT This paper addresses doctor-patient communication about C-sections (CSs) in Shanghai, China. Specifically, we examine the information discrepancies between obstetricians’ and patients’ perceptions of CS and the important factors affecting shared decision-making. We conducted semi-structured individual interviews with 12 postnatal women who experienced CS and with 12 obstetricians. We identified barriers to patient-doctor communication and shared decision-making: obstetricians’ lack of time in outpatient prenatal visits to explain the implications of CSs, family members’ knowledge and opinions on CSs, and information from media and social networks. The lack of communication between the expectant women and the obstetricians was driving the women’s distrust in the latter. The lack of obstetricians’ time to communicate with the pregnant woman led to low trust in the medical staff and overutilization of CS, whereas a lack of financial resources led to underutilization of CS. The obstetricians suggested providing expectant women with more education programs and midwifery support.