Temporal and geographical variation in UK obstetricians’ personal preference regarding mode of delivery

Objective: To assess UK obstetricians’ preferences about mode of delivery for themselves or their partners and determine whether these changed since 1995. Study Design: All 313 registered obstetricians in London and one in five (279) sample of those outside London were sent a structured anonymous postal questionnaire. Results: The response rate was 54%. In a hypothetical uncomplicated first singleton pregnancy with a cephalic presentation at term, 15% chose elective caesarean section (CS) (17% in London versus 13% outside London). The overall rate for London has not changed since 1995 (17 versus 17%), although the difference between women and men was less (31 versus 8% in 1995 and 21 versus 14% in 1999, respectively). The number choosing elective CS increased with estimated foetal weight >4.0kg (40%) and >4.5kg (65%) and with breech presentation both in a first pregnancy (69%) and after a previous vaginal delivery (49%). Conclusion: The overall attitude of London obstetricians to mode of delivery for themselves or their partners has not changed since 1995 and is similar to those of UK obstetricians elsewhere.