(620) Obstetric provider preferences for cesarean delivery on maternal request: a systematic review of the literature

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: The aim of this study is to review obstetrical providers’ personal preferences for cesarean delivery on maternal request (CDMR) in uncomplicated pregnancies.

Study Design: Searches were performed in Ovid-Medline, Cochrane, Scopus, and CINAHL with terms related to “cesarean,” “elective,” “scheduled,” “maternal request,” “physician,” “obstetrician,” “gynecologist,” and “midwife.” There were no limitations placed on the language, year, or location of the studies included in the initial search strategy. Articles were included if they focused on providers’ personal preference for CDMR, if they were written in or translated into English, and if they did not meet any exclusion criteria. The primary outcome was the percentage of providers preferring CDMR in a hypothetical uncomplicated, nulliparous, term, singleton pregnancy in vertex presentation (NTSV). Subgroup analyses included the percentage of providers preferring CDMR for a close family member in a NTSV pregnancy as well as the percentage of providers having a personal history of CDMR.

Results: 34 articles were included in the review. The studies were performed across a range of time and geographical locations. The main providers studied were obstetrician gynecologists (obgyns) and midwives. In a hypothetical scenario asking their personal delivery preference for a NTSV pregnancy, the overall preference for CDMR was 13.5%, specifically 14.3% of obgyns and 2% of midwives. In a hypothetical scenario asking their delivery preference for a close family member in a NTSV pregnancy, these percentages changed to 28.5%, 67%, and 0%, respectively. The percentage of providers with a personal history of CDMR was overall 20.9%, specifically 25.2% of obgyns, and 2% of midwives.

Conclusion: 14.3% of obgyns would prefer a CDMR for themselves in a hypothetical NTSV pregnancy. Additionally, a quarter of obgyns have had a CDMR themselves, and two thirds would recommend it for a close family member. Instead, ≤2% of midwives have had or would recommend a CDMR.

Primary & Presenting Author(s)

Tanvi Rana, BS, MD (she/her/hers)
PGY-1
TriHealth
Cincinnati, Ohio, United States

Coauthor(s)

SS
Syona Satwah, BS
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, Pennsylvania, United States
FB
Federica Bellussi, MD
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, Pennsylvania, United States
Vincenzo Berghella, MD
Professor, Director
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, Pennsylvania, United States