Clinicians’ views regarding caesarean section rates in Switzerland: A cross-sectional web-based survey

Article Article scientifique Article Clinicians’ views regarding caesarean section rates in Switzerland: A cross-sectional web-based survey eng 2023-03 author Mauri Fabio 0000-0003-3789-598X 972564 author Schumacher Fanny 750812 author Weber Marta 991273 author Gayet-Ageron Angèle 668551 Département de santé et médecine communautaire (MECOM) author Martinez De Tejada Weber Begona 590919 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) 100182 10.1016/j.eurox.2023.100182 36879907 2590-1613 PMC9984955 https://linkinghub.elsevier.com/retrieve/pii/S2590161323000078 Objective: The caesarean section (CS) rate in Switzerland is currently 32 %, well above the WHO recommended rate of 15 %. The study aims were three-fold: to explore the perception of this high rate among Swiss obstetrics-gynecology (Ob-Gyn) professionals; to assess the factors associated with a perception of a too high national CS rate; and to describe professionals' opinions on measures to reduce this rate. Study design: A cross-sectional study was conducted between 1 May and 30 June 2021 using an online questionnaire sent to Ob/Gyn physicians and midwives at a university hospital and members of the Swiss Conference of Heads of Ob/Gyn Divisions. Survey participation was voluntary. The main outcome was the belief that CS was high. Associations were explored between different factors and the main outcome with logistic regression. Results were presented as odds ratios (OR) with 95 % confidence intervals (CIs). Multivariate logistic regression included adjustments for age, gender, place of work and profession. Results: Of 226 health professionals invited, 188 completed the questionnaire (83.2 % participation rate). Among respondents, 50.3 % (n = 94) were Ob/Gyn physicians and 49.7 % were midwives (n = 93); 77.1 % were women (n = 145). Most participants (74.7 % [n = 139]) considered the Swiss CS rate as too high and that it should be reduced (79 % [n = 147]) but, notably, they considered their own CS rate as correct (71.9 % [n = 123]). Improving patient education (57.5 % [n = 108]) and professional training (54.8 % [n = 103]) were considered as strategies to reduce this rate. In multivariate analysis, only length of professional experience was significantly associated with a higher likelihood of considering the CS rate as too high (OR 3.07, 95 % CI 1.01-9.30; p = 0.047). When specialty was added in the model, the length of professional experience disappeared and the perception of having a too high CS rate was associated with being a midwife and obstetrician rather than a gynecologist (OR 3.62, 95 % CI 1.72-7.63; p = 0.001). Conclusions: Clinicians, particularly obstetricians, believed that the current rate of CS in Switzerland was too high and that actions were needed to reduce this rate. Improving patient education and professional training were considered as the main strategies to be explored. Caesarean section Clinicians Improvement Perception Rate Switzerland Dewey 613 Dewey 618 64 Département de santé et médecine communautaires 22A 58 Département de pédiatrie, gynécologie et obstétrique 223 217 Centre de recherche clinique 201 false 213 Martinez De Tejada Begona 272 88 Epidémiologie clinique et biostatistique 115 European journal of obstetrics & gynecology and reproductive biology. X 17 9cd58189-cb2c-4cc1-9db5-26233b198ff9 Article (Published version) Public 1-s2.0-S2590161323000078-main.pdf 388643 application/pdf CC BY-ND-4.0 209d5d850ec96c9f72179ce7edf6a24762342b24b3747a3b098390c0fa532c19 openAccess Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Centre de recherche clinique

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Clinicians’ views regarding caesarean section rates in Switzerland: A cross-sectional web-based survey	European journal of obstetrics & gynecology and reproductive biology. X			2023	105	572

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Weber, Marta