European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 136, Issue 1 , Pages 46-52, January 2008

Obstetrician gender and the likelihood of performing a maternal request for a cesarean delivery☆

  • Tsai-Ching Liu

      Affiliations

    • Department of Public Finance, National Taipei University, Taipei, Taiwan
    • Taipei Municipal Wan Fang Hospital, Taipei, Taiwan
    • ,
  • Herng-Ching Lin

      Affiliations

    • School of Health Care Administration, Taipei Medical University, Taiwan
    • Corresponding Author InformationCorresponding author at: School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing St., Taipei 110, Taiwan. Tel.: +886 2 2345 2506x13; fax: +886 2 2378 9788.
    • ,
  • Chin-Shyan Chen

      Affiliations

    • Taipei Municipal Wan Fang Hospital, Taipei, Taiwan
    • Department of Economics, National Taipei University, Taipei, Taiwan
    • ,
  • Hsin-Chien Lee

      Affiliations

    • Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
    • Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan

Received 27 October 2005; received in revised form 14 January 2007; accepted 12 February 2007. published online 09 March 2007.

Abstract 

Objective

To examine the relationship between obstetrician gender and the likelihood of maternal request for cesarean section (CS) within different healthcare institutions (medical centers, regional hospitals, district hospitals, and obstetric and gynecology clinics).

Study design

Five years of population-based data from Taiwan covering 857,920 singleton deliveries without a clinical indication for a CS were subjected to a multiple logistic regression to examine the association between obstetrician gender and the likelihood of maternal request for a CS.

Results

After adjusting for physician and institutional characteristics, it was found that male obstetricians were more likely to perform a requested CS than female obstetricians in district hospitals (OR=1.53) and clinics (OR=2.26), while obstetrician gender had no discernible associations with the likelihood of a CS upon maternal request in medical centers and regional hospitals.

Conclusions

While obstetrician gender had the greatest association with delivery mode decisions in the lowest obstetric care units, those associations were diluted in higher-level healthcare institutions.

Keywords: Maternal request, Cesarean section, Physician gender, Clinic, Obstetrician

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☆ Sources of information for the study: Secondary data released from Taiwan's National Health Insurance Research Database which included no patient, institution, or physician identifiers.

PII: S0301-2115(07)00085-1

doi:10.1016/j.ejogrb.2007.02.007

European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 136, Issue 1 , Pages 46-52, January 2008

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