The influence of individual provider characteristics and attitudes on caesarean section decision-making: a global review

Abstract

Caesarean section (CS) rates have risen worldwide in the past two decades, particularly in middle and high-income countries. In addition to changing maternal and health system factors, there is growing evidence that provider factors may contribute to rising unnecessary caesareans. The aim of this review was to assess the evidence for the association between individual provider characteristics, attitudes towards CS and decision-making for CS. A search was conducted in May 2018 in PubMed and Web of Science with 23 papers included in our final review. Our results show that higher anxiety scores and more favourable opinions of CS were associated with increased likelihood of performing CS. These findings highlight a need for appropriate interventions to target provider attitudes towards CS to reduce unnecessary procedures.

Keywords:

• Caesarean delivery
• provider
• obstetrician
• midwife
• attitudes

Acknowledgments

We would like to thank the following people within Polygeia who provided input to this project along the way: Frederick Stourton, Lotte Elton, Sachin Sharma, Nur Kara, Maya Malarski, Louise Han, and Niamh Spence.

Disclosure statement

None of the authors would like to express any conflict of interest. There was no specific funding for this project.