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LETTER TO EDITOR
Year : 2014  |  Volume : 3  |  Issue : 2  |  Page : 127

Opting the mode of delivery: Conflict of intentions or synchronous convention between physicians and mothers


1 Student Research Committee, Babol University of Medical Sciences, Babol, Iran
2 Family Physician, Mashad University of Medical Sciences, Mashad, Iran
3 Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

Date of Web Publication20-Jun-2014

Correspondence Address:
Amin Zarghami
Student Research Committee, Babol University of Medical Sciences, Ganjafrouz Av, Babol, Mazandaran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-0521.134869

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How to cite this article:
Zarghami A, Nazari P, Zarghami A. Opting the mode of delivery: Conflict of intentions or synchronous convention between physicians and mothers. Saudi J Health Sci 2014;3:127

How to cite this URL:
Zarghami A, Nazari P, Zarghami A. Opting the mode of delivery: Conflict of intentions or synchronous convention between physicians and mothers. Saudi J Health Sci [serial online] 2014 [cited 2021 Jul 24];3:127. Available from: https://www.saudijhealthsci.org/text.asp?2014/3/2/127/134869

Dear Sir,

We read with interest the review by Das A in a recent issue of the Saudi Journal for Health Sciences in which the conflicts in Cesarean delivery on maternal request has been skillfully discussed. [1] It is known that the number of pregnant women requesting delivery by elective Cesarean section (CS) without an accepted medical indication is dramatically increasing [2] and the respond of physicians is ambiguous.

Author attributed high rate of CS to several major etiologies such as lack of offering pain relief in anesthetic stage, low rate of successful vaginal birth after Cesarean, view of junior obstetricians about Cesarean section as an accepted mode of delivery, etc., but in our study we retrieved different data. Fear of labor pain, fear of fetal damage during vaginal delivery and consulting with other family members and relatives affect the choice of CS by maternal request. In contrast for/to? the vaginal delivery group, the side effect of surgery to mother, knowledge and consult with health professionals were the most frequent factors associated in opting VD.

The key point of literatures have been published so far, is that different populations may have encountered with different factors associated in selecting the method of delivery but to our opinion the critical missing point in this issue is the key role of physician, obstetrician, and midwifery in the process of decision making among pregnant women. In our study, the number of mothers who consult with obstetrician and then selected CS was significantly more than those without any consultant for opting the delivery method. This finding arises two hypotheses in which pregnant women previously chose the method of delivery and the obstetrician would not make effort to change or the process of consulting was malfunctioned and visits were not too effective to make a logical decision based on medical indication. On the other hand 40% of those experienced vaginal delivery mentioned that consulting with family physician and midwifery was the most important factor associated with choosing VD. [3] Previous retrospective studies indicated that patients of family physicians may be less likely to undergo CS than patients cared by their obstetricians. [4]

As the author finally concluded health care workers, particularly obstetricians should establish the reasons for the request and make sure that women and their partners would be found out the associated risk factors, benefits and the process of intervention by providing valid and reliable information through evidenced based medicine. [1] On the other hand, building an effective and trustworthy rapport between the physician and primiparous women should not be underestimated. Besides, physicians must consider ethical considerations. [5]

 
  References Top

1.Das A. Cesarean delivery on maternal request. Saudi J Health Sci 2013;2:141-5.  Back to cited text no. 1
  Medknow Journal  
2.Yilmaz SD, Bal MD, Beji NK, Uludag S. Women′s preferences of method of delivery and influencing factors. Iran Red Crescent Med J 2013;15:683-9.  Back to cited text no. 2
    
3.Ghadimi R, Izadpanah F, Zarghami A, Rajabi M, Baleghi M. Effective factors for choosing the delivery method in primiparous women in Babol 2010: A postpartum survey. J Babol Univ Med Sci 2013;15:52-8.  Back to cited text no. 3
    
4.Coco AS, Gates TJ, Gallagher ME, Horst MA. Association of attending physician specialty with the cesarean delivery rate in the same patient population. Fam Med 2000;32:639-44.  Back to cited text no. 4
    
5.Hannah ME. Planned elective cesarean section: A reasonable choice for some women? CMAJ 2004;170:813-4.  Back to cited text no. 5
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