Die „Wunschsektio“. Ergebnisse einer Umfrage unter den Gynäkologinnen und Gynäkologen Bayerns

Abstract

Objective: We surveyed the attitudes of practicing obstetrician-gynecologists to elective cesarean delivery in light of their personal experience and estimated the effects of elective cesarean delivery on the overall rate of cesarean delivery. Methods: In January 2002 we sent questionnaires to all 1502 practicing obstetrician-gynecologists and the chairpersons of all 164 obstetric units in Bavaria. Results: The response rate was 36% (594/1666). 7.6% of practicing obstetricians and 8.7% of department chairpersons would prefer elective cesarean delivery for themselves or their partner for an uncomplicated pregnancy with cephalic presentation. There were no differences regarding age or sex of the respondents. All obstetricians who themselves or their partner had had an operative vaginal delivery would retrospectively prefer vaginal over cesarean delivery for themselves or their partner. 56% (292/525) of practicing physicians agreed that the option of elective cesarean delivery should be available. 71 % (49(69) of obstetric units performed elective cesarean deliveries, 29% (20) did not. The cesarean delivery rates at units offering elective cesarean delivery did not differ from that at units that did not. Elective cesarean deliveries were estimated to account for 6.2% of all cesarean deliveries at the units where it was available. Conclusion: Most practicing obstetricians, both male and female, in Bavaria prefer vaginal delivery. However, elective cesarean delivery is accepted by an increasing number of practicing physicians and department chairpersons. There does not appear to be an effect on the overall rate of cesarean delivery.