Preferência pessoal da médica obstetra em relação ao seu próprio parto: vaginal ou cesariana.

Abstract

Brazil has one of the highest prevalence of cesarean births in the world. Many point to obstetricians as being responsible for this, suggesting that their practices are based on particular interests, such as financial gain and convenience, to the detriment of the health and well-being of their patients. One way to begin to resolve this question is to find out how the obstetricians´ own children are being born, in order to know whether they choose for themselves what they offer to their patients. Objective: To estimate the personal preference and prevalence of cesarean sections in obstetricians in a sample in the State of Rio de Janeiro and worldwide. Methods: Two studies were carried out: a narrative review of the literature and a sectional study in Rio de Janeiro State, with a self-administered questionnaire. In the literature review, we selected studies that estimated the personal preference for cesarean section and the prevalence of cesarean section among obstetricians. The sectional study used a confidential self-administered questionnaire answered by a convenience sample of obstetricians of both sexes (and trainees of obstetrics) in the state of Rio de Janeiro. These professionals were approached during two specialty conferences and at four public hospitals located in the State of Rio de Janeiro. We estimated the prevalence of already performed or desired / planned cesarean sections and 95% confidence intervals. Results: The prevalence of cesareans in obstetricians in the world showed great variation, as did their personal preferences for cesarean section. The personal preference and prevalence of cesarean sections in the sample of obstetricians in Rio de Janeiro were 29% and 80%, respectively. Conclusion: The large variation in the results of the studies on preference and mode of delivery among obstetricians found in different countries suggests that cultural, economic and childbirth care factors play an important role in the determination of cesarean rates. The high personal preference and high prevalence of cesarean delivery that we found among obstetricians in Rio de Janeiro suggest that these professionals have great confidence in the cesarean section, to the point that most of their children are born through this mode of delivery.