Repeat cesarean section and primary elective cesarean section: Recently trained obstetrician-gynecologist practice patterns and opinions

This study was undertaken to determine opinions of obstetrician-gynecologists regarding vaginal birth after cesarean (VBAC) section and elective cesarean section. A questionnaire was administered to obstetrician-gynecologists attending 2 review courses. Of 500 obstetrician-gynecologists, 304 complet...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2005-06, Vol.192 (6), p.1872-1875
Main Authors: Kenton, Kimberly, Brincat, Cynthia, Mutone, Martina, Brubaker, Linda
Format: Article
Language:English
Subjects:
Adult
Cesarean section
Cesarean Section - utilization
Cesarean Section, Repeat - utilization
Education, Medical, Continuing
Elective Surgical Procedures - utilization
Fecal Incontinence - prevention & control
Female
Humans
Incontinence
Male
Middle Aged
Obstetrics - education
Pelvic floor
Practice Patterns, Physicians' - statistics & numerical data
Pregnancy
Surveys and Questionnaires
United States - epidemiology
Urinary Incontinence, Stress - prevention & control
Vaginal birth
Vaginal Birth after Cesarean - utilization
Vaginal birth after cesarean section
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Summary:This study was undertaken to determine opinions of obstetrician-gynecologists regarding vaginal birth after cesarean (VBAC) section and elective cesarean section. A questionnaire was administered to obstetrician-gynecologists attending 2 review courses. Of 500 obstetrician-gynecologists, 304 completed the survey for a response rate of 61%. Most (92%) counseled VBAC candidates differently, and 84% quoted differential VBAC completion rates on the basis of the indication for prior cesarean section. Uterine rupture was virtually always discussed (99%). Pelvic floor risks were infrequently discussed with urinary incontinence, pelvic organ prolapse, and fecal incontinence discussed by less than one third of obstetricians (30%, 28%, and 25%, respectively). Fifty-nine percent of physicians would perform a primary elective cesarean section, and 67% would perform a primary elective cesarean section specifically to prevent pelvic floor disorders. Two thirds of recent graduates are willing to perform an elective cesarean section to prevent pelvic floor injury. Most offer VBAC; however, less than a third include risk of pelvic floor injury in their informed consent discussions.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2005.01.046