A national confidential survey of obstetrician's personal preferences regarding mode of delivery

Objective: To survey the personal preferences of obstetricians regarding mo de of delivery, and relate these to hospital caesarean section rates. Study Design: A confidential, questionnaire based survey to all obstetricians wo rking in the Republic of Ireland (n = 234). Results: The response rate was 71% (n = 165). Seven percent of Irish obstetricians would choose an electiv e caesarean section for themselves (or their partners) if they were primigr avida with an uncomplicated, singleton cephalic presentation at term in the absence of any clinical indication. Caesarean section was the preferred mo de of delivery for 38% of respondents if the estimated foetal weight was 4. 5 kg. There was a highly significant association between consultant obstetr icians' personal preferences of towards caesarean section and their working in a hospital with a caesarean section rate greater than 16% (P < 0.005). Conclusions: Irish obstetricians' personal preferences towards elective cae sarean section for an uncomplicated, cephalic pregnancy at term are signifi cantly lower than published data examining London based obstetricians' choi ces. There is a consistent trend against vaginal delivery if the obstetrici an is female or younger. The association between a personal preference of t he consultant for abdominal delivery and the caesarean section rate of the hospital that they work in may hamper efforts to decrease the rising number s of caesarean sections. (C) 2001 Published by Elsevier Science Ireland Ltd .