Personal preferences of obstetricians towards childbirth

Our objective was to determine obstetricians' personal choices in relation to modes of delivery and long-term outcomes. A structured confidential survey was mailed out to all Australian and New Zealand Fellows, Members, and Australian Trainees with The Australian and New Zealand Journal of Obstetrics and Gynaecology November 1999 edition. The response rate overall was 26% (478). Eleven per cent (54) chose to have an elective Caesarean section (ECS) in the absence of any clinical indication. The most common reason for this was fear of faecal and urinary incontinence (82%). Two-thirds (318) were agreeable to patients requesting an ECS in this same setting. Twenty-six per cent said they would choose ECS if the estimated fetal weight (EFW) was > 4000 g which more than doubled to 55% (261) if EFW was > 4500 g. Ventouse delivery was the most popular method of assisted rotational delivery at 45% (214) followed closely by Keilland's forceps at 40% (189). Caesarean section (CS) was chosen by only 14% (65) in this scenario. ECS was the preferred method for breech delivery at 38% (181) followed by trial of breech delivery at 23% (109). Thirty-two per cent (154) of respondents would attempt external cephalic version prior to deciding mode of delivery. Respondents felt the most important factors for postnatal incontinence included: antenatal incontinence (64%), length of second stage > one hour (50%), forceps delivery (46%), and EFW > 4000 g at term (44%).