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Providers Greatly Influence Women’s Decision to have C-sections, Inductions

Update Date: Sep 23, 2014 12:34 PM EDT
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Cesarean sections and inductions are delivery options that are typically recommended for pregnant women who are at-risk of complications. However, over the past years, women have chosen to get either one of these procedures due to non-medical reasons, such as timing and convenience. In some cases, women are opting for a C-section or induction even though they do not have any medical reason to do so after feeling pressured by their obstetrical care providers, a new study found.

Even though C-sections and inductions are considered to be safe, several studies have found that they increase the newborns' risk of developing health problems. These procedures can also increase people's health care costs. Some of these studies have concluded that if the pregnancy is normal, women should have a natural delivery.

In this study, the researchers analyzed data gathered by the Listening to Mothers II Survey, which included 2,400 women aged 18 to 45. The women had given birth to one infant between July 2011 and June 2012. The survey asked them questions about whether or not they felt pressured to have a C-section or induction by their obstetrical care provider. The survey also collected information on whether or not they had these procedures and why they chose to do them.

Overall, 14.8 percent of the women stated that they felt pressured to have an induction. In this group, the women were 3.5 times more likely to have induction. In terms of C-sections, 13.3 percent felt pressured and these women were five times more likely to undergo a C-section in comparison to women who did not feel pressured by their provider.

"This may be an issue of miscommunication or misperception between patients and their providers," stated study author Katy B. Kozhimannil, of the Division of Health Policy and Management at the University of Minnesota School of Public Health reported by Medical Xpress. "But the fact is, [perceived pressure] is a strong predictor of the use of these procedures during labor and delivery."

Erin Myers, M.D., an obstetrician-gynecologist at Greater Baltimore Medical Center, stated that the rapport between providers and patients should be improved upon. Providers might need to spend extra time explaining the difference between the delivery options and why one might be a better option.

"The problem with the health care system is that we don't have hours to talk with patients, so we are forced to explain complicated medical decisions in a limited time period," Myers said.

The study, "Patient-perceived pressure from clinicians for labor induction and cesarean delivery: A population-based survey of U.S. women," was published in the journal, Health Services Research.

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