Abstract
Objective
The aim of this study is to review obstetric providers’ personal preferences for cesarean
delivery on maternal request (CDMR) in uncomplicated pregnancies.
Data sources
Searches were performed in Ovid-Medline, Cochrane, Scopus, CINAHL with terms related
to “cesarean,” “elective,” “scheduled,” “maternal request,” “physician,” “obstetrician,”
“gynecologist,” “midwife,” “specialist,” and “trainee.” There were no limitations
placed on the language, year, or location of the studies included in the initial search
strategy.
Study eligibility criteria
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.
Study appraisal and synthesis methods
The primary outcome was the percentage of providers preferring CDMR in a hypothetical
uncomplicated nulliparous term singleton vertex (NTSV) pregnancy. Secondary outcomes
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
(ob-gyns) and midwives. In the hypothetical scenario asking their personal delivery preference for a NTSV pregnancy, the overall preference for CDMR among all
obstetric providers was 13.5% (966/7154), specifically 14.3% (894/6250) of ob-gyns
and 2% (11/574) of midwives; these percentages increased over the last 20 years. In
the hypothetical scenario asking their delivery preference for a close family member in a NTSV pregnancy, these percentages changed to 28.5% (138/484), 67% (138/206),
and 0% (0/278), respectively. The percentage of providers with a personal history
of CDMR was overall 20.9% (486/2324), specifically 25.2% (338/1339) of ob-gyns, and
2% (7/347) of midwives.
Conclusions
14.3% of ob-gyns would prefer CDMR for themselves in a hypothetical NTSV pregnancy,
and this percentage has increased over the last 20 years. However, 25.2% of ob-gyns
have had CDMR themselves, and 67% would recommend it for a close family member. Instead,
≤2% of midwives have had or would recommend CDMR.
Keywords
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Article info
Publication history
Accepted:
December 14,
2022
Received in revised form:
December 6,
2022
Received:
September 22,
2022
Publication stage
In Press Accepted ManuscriptFootnotes
Conflicts of Interest: The authors have no conflicts of interest, financial or otherwise, to disclose.
PROSPERO Registration ID: CRD42022368578
Condensation: 25.2% ob-gyns have had a CDMR and 67% would recommend it for close family members. ≤2% of midwives have had or would recommend a CDMR.
Identification
Copyright
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