The DOI matches its Crossref record; 53 of the 59 references it cites were found in a registry or an index, and 5 are not checked yet.
Clinicians’ views of factors influencing decision-making for caesarean section: A systematic review and metasynthesis of qualitative, quantitative and mixed methods studies
Open accessAbstract
BACKGROUND: Caesarean section rates are increasing worldwide and are a growing concern with limited explanation of the factors that influence the rising trend. Understanding obstetricians' and midwives' views can give insight to the problem. This systematic review aimed to offer insight and understanding, through aggregation, summary, synthesis and interpretation of findings from studies that report obstetricians' and midwives' views on the factors that influence the decision to perform caesarean section. METHODS: The electronic databases of PubMed (1958-2016), CINAHL (1988-2016), Maternity and Infant Care (1971-2016), PsycINFO (1980-2016) and Web of Science (1991-2016) were searched in September 2016. All quantitative, qualitative and mixed methods studies, published in English, whose aim was to explore obstetricians' and/or midwives' views of factors influencing decision-making for caesarean section were included. Papers were independently reviewed by two authors for selection by title, abstract and full text. Thomas et al's 12 assessment criteria checklist (2003) was used to assess methodological quality of the included studies. RESULT: The review included 34 studies: 19 quantitative, 14 qualitative, and one using mixed methods, involving 7785 obstetricians and 1197 midwives from 20 countries. Three main themes, each with several subthemes, emerged. Theme 1: "clinicians' personal beliefs"-('Professional philosophies'; 'beliefs in relation to women's request for CS'; 'ambiguous versus clear clinical reasons'); Theme 2: "health care systems"-('litigation'; 'resources'; 'private versus public/insurance/payments'; 'guidelines and management policy'). Theme 3: "clinicians' characteristics" ('personal convenience'; 'clinicians' demographics'; 'confidence and skills'). CONCLUSION: This systematic review and metasynthesis identified clinicians' personal beliefs as a major factor that influenced the decision to perform caesarean section, further contributed by the influence of factors related to the health care system and clinicians' characteristics. Obstetricians and midwives are directly involved in the decision to perform a caesarean section, hence their perspectives are vital in understanding various factors that have influence on decision-making for caesarean section. These results can help clinicians identify and acknowledge their role as crucial members in the decision-making process for caesarean section within their organisation, and to develop intervention studies to reduce caesarean section rates in future.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“and institutional limitations in health facilities”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014
Betrán, A. P., Ye, J., Moller, A.-B., Zhang, J., Gülmezoglu, A. M., & Torloni, M. R. (2016) · PLoS ONE · doi:10.1371/journal.pone.0148343 · Cited by 2,250
Vogel, J. P., Betrán, A. P., Vindevoghel, N., Souza, J. P., Torloni, M. R., Zhang, J., Tunçalp, Ö., Mori, R., Morisaki, N., Ortiz‐Panozo, E., et al. (2015) · The Lancet Global Health · doi:10.1016/s2214-109x(15)70094-x · Cited by 1,038
Lucas, P. J., Baird, J., Arai, L., Law, C., & Roberts, H. M. (2007) · BMC Medical Research Methodology · doi:10.1186/1471-2288-7-4 · Cited by 567
Ng, S., Cameron, C. M., Hills, A. P., McClure, R., & Scuffham, P. (2014) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-14-314 · Cited by 398
Indications for and Risks of Elective Cesarean Section
Mylonas, I. G., & Friese, K. (2015) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2015.0489 · Cited by 389
Raza, W. A., de Poel, E. V., Panda, P. K., Dror, D. M., & Bedi, A. S. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-1254-9 · Cited by 351
Mazzoni, A., Althabe, F., Liu, N., Bonotti, A., Gibbons, L., Sánchez, A., & Belizán, J. (2011) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2010.02793.x · Cited by 306
Psychometric properties of the Swedish childbirth self-efficacy inventory (Swe-CBSEI)
Carlsson, I., Ziegert, K., & Nissen, E. (2014) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-14-1 · Cited by 295
Weaver, J. J., Statham, H., & Richards, M. (2007) · Birth · doi:10.1111/j.1523-536x.2006.00144.x · Cited by 203
Cesarean Delivery on Maternal Request
Bettes, B. A., Coleman‐Cowger, V. H., Zinberg, S., Spong, C. Y., Portnoy, B., DeVoto, E., & Schulkin, J. A. (2007) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000249608.11864.b6 · Cited by 162
(2003) · UCL Discovery (University College London) · Cited by 162
Yazdizadeh, B., Nedjat, S., Mohammad, K., Rashidian, A., Changizi, N., & Majdzadeh, R. (2011) · BMC Health Services Research · doi:10.1186/1472-6963-11-159 · Cited by 141
Fuglenes, D., Øian, P., & Kristiansen, I. S. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2008.07.021 · Cited by 127
Cotzias, C. S., Paterson‐Brown, S., & Fisk, N. M. (2001) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/s0301-2115(00)00360-2 · Cited by 125
Bergholt, T., Østberg, B., Legarth, J., & Weber, T. (2004) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/j.0001-6349.2004.0312.x · Cited by 107
Caesarean birth: Consumption, safety, order, and good mothering
Bryant, J., Porter, M., Tracy, S., & Sullivan, E. (2007) · Social Science & Medicine · doi:10.1016/j.socscimed.2007.05.025 · Cited by 101
Chaillet, N. (2007) · Bulletin of the World Health Organization · doi:10.2471/blt.06.039289 · Cited by 98
Burke, N., Burke, G., Breathnach, F., McAuliffe, F. M., Morrison, J. J., Turner, M. J., Dornan, S., Higgins, J. R., Cotter, A. M., Geary, M. P., et al. (2017) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.02.017 · Cited by 90
Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study
Mazzoni, A., Althabe, F., Gutiérrez, L., Gibbons, L., Liu, N. H., Bonotti, A. M., Izbizky, G. H., Ferrary, M., Viergue, N., Vigil, S. I., et al. (2016) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-016-0824-0 · Cited by 87
Litorp, H., Mgaya, A. H., Mbekenga, C. K., Kidanto, H. L., Johnsdotter, S., & Essén, B. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.09.003 · Cited by 79
Obstetricians’ and Midwives’ Attitudes toward Cesarean Section
Monari, F., Mario, S. D., Facchinetti, F., & Basevi, V. (2008) · Birth · doi:10.1111/j.1523-536x.2008.00226.x · Cited by 78
Litorp, H., Mgaya, A. H., Kidanto, H. L., Johnsdotter, S., & Essén, B. (2015) · Midwifery · doi:10.1016/j.midw.2015.03.008 · Cited by 75
Private health care coverage and increased risk of obstetric intervention
Lutomski, J. E., Murphy, M., Devane, D., Meaney, S., & Greene, R. A. (2014) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-14-13 · Cited by 71
Kamal, P., Dixon‐Woods, M., Kurinczuk, J. J., Oppenheimer, C. A., Squire, P., & Waugh, J. J. S. (2005) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2005.00647.x · Cited by 68
Bagheri, A., Alavi, N. M., & Abbaszadeh, F. (2012) · Women and Birth · doi:10.1016/j.wombi.2012.09.004 · Cited by 64
Indications for primary cesarean delivery relative to body mass index
Kawakita, T., Reddy, U. M., Landy, H. J., Iqbal, S. N., Huang, C.-C., & Grantz, K. L. (2016) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2016.05.023 · Cited by 63
Swedish caregivers’ attitudes towards caesarean section on maternal request
Karlström, A., Engström‐Olofsson, R., Nystedt, A., Thomas, J. E., & Hildingsson, I. (2009) · Women and Birth · doi:10.1016/j.wombi.2008.12.002 · Cited by 62
Cox, K. J. (2011) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-11-72 · Cited by 61
Caesarean section on request: a survey in The Netherlands
Kwee, A., Cohlen, B. J., Kanhai, H. H. H., Bruinse, H. W., & Visser, G. H. A. (2004) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2003.09.017 · Cited by 57
Arıkan, D. C., Özer, A., Arıkan, İ., Coşkun, A., & Kıran, H. (2010) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-010-1682-z · Cited by 46
Intrapartum Nurses’ Perceived Influence on Delivery Mode Decisions and Outcomes
Edmonds, J. K., & Jones, E. J. (2012) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/j.1552-6909.2012.01422.x · Cited by 46
Obstetric and gynecologic malpractice claims in Saudi Arabia: Incidence and cause
Aldakhil, L. O. (2016) · Journal of Forensic and Legal Medicine · doi:10.1016/j.jflm.2016.02.001 · Cited by 39
Factors associated with caesarean sections in Phnom Penh, Cambodia
Schantz, C., Sim, K. L., Petit, V., Rany, H., & Goyet, S. (2016) · Reproductive Health Matters · doi:10.1016/j.rhm.2016.11.009 · Cited by 36
Huang, K., Tao, F., Faragher, B. E., Raven, J., Tolhurst, R., Tang, S., & van den Broek, N. R. (2013) · Midwifery · doi:10.1016/j.midw.2012.11.003 · Cited by 36
Marshall, J. L., Spiby, H., & McCormick, F. M. (2014) · Midwifery · doi:10.1016/j.midw.2014.10.005 · Cited by 35
Kenton, K. S., Brincat, C., Mutone, M. F., & Brubaker, L. T. (2005) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2005.01.046 · Cited by 34
The policy environment encouraging C-section in Lebanon
Kabakian‐Khasholian, T., Kaddour, A., DeJong, J., Shayboub, R., & Nassar, A. H. (2006) · Health Policy · doi:10.1016/j.healthpol.2006.11.006 · Cited by 33
Foureur, M. J., Turkmani, S., Clack, D., Davis, D. L., Mollart, L. J., Leiser, B., & Homer, C. (2016) · Women and Birth · doi:10.1016/j.wombi.2016.05.011 · Cited by 32
Mode of Childbirth in Low-Risk Pregnancies: Nicaraguan Physicians’ Viewpoints
Colomar, M., Cafferata, M. L., Alemán, A., Castellano, G., García‐Elorrio, E., Althabe, F., & Engelbrecht, S. M. (2014) · Maternal and Child Health Journal · doi:10.1007/s10995-014-1478-z · Cited by 31
Caesarean Delivery Rate Review: An Evidence-Based Analysis.
Degani, N., & Sikich, N. (2015) · Europe PMC (PubMed Central) · Cited by 30
The decision to perform Caesarean section in Russia
Danishevski, K., McKee, M., Sassi, F., & Maltcev, V. (2007) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzm070 · Cited by 26
Knowledge and attitudes about vaginal birth after Caesarean section in Australian hospitals
Appleton, B., Targett, C. S., Rasmussen, M., Readman, E., Sale, F., Permezel, M., & The VBAC Study Group (2000) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.1479-828x.2000.tb01146.x · Cited by 23
Zhao, Y., Zhang, J., Zamora, J., Vogel, J. P., Souza, J. P., Jayaratne, K., Ganchimeg, T., Ortiz‐Panozo, E., Hernández, B., Oladapo, O. T., et al. (2017) · Paediatric and Perinatal Epidemiology · doi:10.1111/ppe.12363 · Cited by 22
Fehervary, P., Schwarz, K., Bauer, L., & Melchert, F. (2005) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2005.01.016 · Cited by 21
Vaginal birth after cesarean delivery: practice patterns of obstetrician-gynecologists.
Coleman‐Cowger, V. H., Erickson, K., Schulkin, J. A., Zinberg, S., & Sachs, B. P. (2005) · PubMed · Cited by 21
Predictors of caesarean section – a cross-sectional study in Hungary
Rénes, L., Barka, N., Gyurkovits, Z., Paulik, E., Németh, G., & Orvos, H. (2017) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2017.1285888 · Cited by 19
The use of quality control performance charts to analyze cesarean delivery rates nationally
Turner, M. J. (2011) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2011.01.012 · Cited by 18
A Comparison Between Swedish Midwives and Obstetricians & Gynecologists Opinions on Cesarean Section
Josefsson, A., Gunnervik, C., Sydsjö, A., & Sydsjö, G. (2010) · Maternal and Child Health Journal · doi:10.1007/s10995-010-0630-7 · Cited by 17
South African obstetricians' views on caesarean section.
CHALMERS, B. E., McIntyre, J. A., & Meyer, D. (1992) · PubMed · Cited by 17
Differences in nulliparous caesarean section rates across models of care: a decomposition analysis
Brick, A., Layte, R., Nolan, A., & Turner, M. J. (2016) · BMC Health Services Research · doi:10.1186/s12913-016-1494-3 · Cited by 16
Obstetricians' attitudes to caesarean delivery on maternal request in Nigeria
Chigbu, C. O., Ezenyeaku, C. C. T., & Ezenkwele, E. P. (2010) · Journal of Obstetrics and Gynaecology · doi:10.3109/01443615.2010.489165 · Cited by 16
Doret, M., Touzet, S., Bourdy, S., & Gaucherand, P. (2010) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767051003678176 · Cited by 14
Exploring Trends in the Rate of Caesarean Section in Ireland 1999-2007
Brick, A., & Layte, R. (2011) · RePEc: Research Papers in Economics · Cited by 13
Bailit, J. L., Schulkin, J. A., & Dawson, N. V. (2007) · PubMed · Cited by 11
Coleman‐Cowger, V. H., Erickson, K., Spong, C. Y., Portnoy, B., Croswell, J. M., & Schulkin, J. A. (2010) · PubMed · Cited by 10
Koigi-Kamau, R., Leting, P., & Kiarie, J. N. (2006) · East African Medical Journal · doi:10.4314/eamj.v82i12.9368 · Cited by 8
Attitudes of Obstetricians toward Cesarean Delivery in Challenging Cases
Samadi, S., Gholizadeh, N., Shoar, N., & Shoar, S. (2013) · The Journal of Obstetrics and Gynecology of India · doi:10.1007/s13224-013-0401-7 · Cited by 6
Vaginal Birth After Cesarean Delivery: Practice Patterns of Obstetrician???Gynecologists
Coleman, V. H., Erickson, K., Schulkin, J., Zinberg, S., & Sachs, B. P. (2005) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000180847.45288.49
Flagged first, then by citations
1 of the 59 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- L Gibbons, 2010, The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage, World Health Report
Cited by
Sorted by citations
Wilson, R. D., Caughey, A. B., Wood, S. L., Macones, G. A., Wrench, I. J., Huang, J., Norman, M., Pettersson, K., Fawcett, W. J., Shalabi, M. M., et al. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2018.09.015 · Cited by 315
Hirsh‐Yechezkel, G., Glasser, S., Farhi, A., Levitan, G., Shachar, Y., Zaslavsky‐Paltiel, I., Boyko, V., Ezra, Y., & Lerner‐Geva, L. (2022) · Women s Health · doi:10.1177/17455057221125366 · Cited by 157
Shared decision‐making in maternity care: Acknowledging and overcoming epistemic defeaters
Begley, K., Daly, D., Panda, S., & Begley, C. (2019) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.13243 · Cited by 125
Self-citationWhat are women’s mode of birth preferences and why? A systematic scoping review
Coates, D., Thirukumar, P., Spear, V., Brown, G. A., & Henry, A. (2019) · Women and Birth · doi:10.1016/j.wombi.2019.09.005 · Cited by 103
Elite female athletes’ experiences of symptoms of pelvic floor dysfunction: A systematic review
Culleton-Quinn, E., Bø, K., Fleming, N., Mockler, D., Cusack, C., & Daly, D. (2022) · International Urogynecology Journal · doi:10.1007/s00192-022-05302-6 · Cited by 88
Self-citation
Metadata
- Authors
- Panda, S., Begley, C., & Daly, D.
- Affiliations
- Trinity College Dublin (IE)
- Corresponding author
- Panda, Sunita
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-07-27
- Volume
- 13
- Issue
- 7
- Pages
- e0200941
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6063415
- OpenAlex
- W2883011608
- Cited by
- 165
- References
- 59
- Citations by year
- 2026: 16 · 2025: 14 · 2024: 31 · 2023: 27 · 2022: 22 · 2021: 24 · 2020: 16 · 2019: 12 · 2018: 3
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Update notices
- correction (2018-08-15)
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-sa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Trinity's Access to Research Output (TARA) (Trinity College Dublin) (submittedVersion)
- Funders
- Health Research Board (HPF-2016-1671)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
- Keywords
- cesarean section, cesarean section rate, clinical decision-making, midwives' perceptions, clinician beliefs, health system factors, litigation, clinical guidelines, resource availability
- MeSH terms
- Cesarean Section, Decision Making, Health Personnel, Humans, Health Knowledge, Attitudes, Practice, Midwifery, Obstetrics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
