Cesarean or vaginal delivery for the breech fetus at the threshold of viability: results from a maternal–fetal medicine specialists survey

Deutsch, Aaron; Duncan, Karen A.; Rajaram, Lakshminarayan; Salihu, Hamisu M.; Spellacy, William N.; Belogolovkin, Victoria

doi:10.3109/14767058.2010.510895

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…There were several limitations to the current study. Although this study included a fairly large sample of MFMs ( N = 278), our population was too small to support statistically significant findings and others have shown higher recruitment rates of MFMs using physical mailings . Recruiting by email allowed multiple MFMs from one institution to answer the survey, and although the vast majority of email domains used indicates practice at US institutions, we failed to exclude non‐US practitioners.…”

Section: Discussionmentioning

confidence: 90%

Clinical implementation of noninvasive prenatal testing among maternal fetal medicine specialists

et al. 2014

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Section: Discussionmentioning

confidence: 90%

Clinical implementation of noninvasive prenatal testing among maternal fetal medicine specialists

et al. 2014

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“…The legal environment and how it influences maternity care were the focus of 24 studies 13 14 21 22 33–38 41 43 46 47 49 50 52 54 62 63 76–79. While laws, legal norms and procedures differ by context, we identified common themes across different studies.…”

Section: Resultsmentioning

confidence: 99%

Behavioural factors associated with fear of litigation as a driver for the increased use of caesarean sections: a scoping review

et al. 2023

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ObjectiveTo explore the behavioural drivers of fear of litigation among healthcare providers influencing caesarean section (CS) rates.DesignScoping review.Data sourcesWe searched MEDLINE, Scopus and WHO Global Index (1 January 2001 to 9 March 2022).Data extraction and synthesisData were extracted using a form specifically designed for this review and we conducted content analysis using textual coding for relevant themes. We used the WHO principles for the adoption of a behavioural science perspective in public health developed by the WHO Technical Advisory Group for Behavioural Sciences and Insights to organise and analyse the findings. We used a narrative approach to summarise the findings.ResultsWe screened 2968 citations and 56 were included. Reviewed articles did not use a standard measure of influence of fear of litigation on provider’s behaviour. None of the studies used a clear theoretical framework to discuss the behavioural drivers of fear of litigation. We identified 12 drivers under the three domains of the WHO principles: (1) cognitive drivers: availability bias, ambiguity aversion, relative risk bias, commission bias and loss aversion bias; (2) social and cultural drivers: patient pressure, social norms and blame culture and (3) environmental drivers: legal, insurance, medical and professional, and media. Cognitive biases were the most discussed drivers of fear of litigation, followed by legal environment and patient pressure.ConclusionsDespite the lack of consensus on a definition or measurement, we found that fear of litigation as a driver for rising CS rates results from a complex interaction between cognitive, social and environmental drivers. Many of our findings were transferable across geographical and practice settings. Behavioural interventions that consider these drivers are crucial to address the fear of litigation as part of strategies to reduce CS.

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“…This finding is in line with previous research that suggests MFM specialists will recommend cesarean despite believing there is insufficient evidence to support this recommendation. 21 It is plausible that the discrepancy between practice patterns and personal beliefs about intervention may stem from a desire to adhere to patient preferences or from practice patterns that align more with institutional norms for intervention than providers' own beliefs about periviable cesarean.…”

Section: Discussionmentioning

confidence: 99%

Do maternal characteristics influence maternal–fetal medicine physicians’ willingness to intervene when managing periviable deliveries?

2016

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Cesarean or vaginal delivery for the breech fetus at the threshold of viability: results from a maternal–fetal medicine specialists survey

Abstract: The majority of U.S. maternal fetal-medicine specialists who responded would recommend cesarean delivery for a breech fetus at the threshold of viability, despite the belief that there is inadequate evidence in the literature to support this recommendation.

Cited by 6 publications

References 22 publications

Clinical implementation of noninvasive prenatal testing among maternal fetal medicine specialists

Clinical implementation of noninvasive prenatal testing among maternal fetal medicine specialists

Behavioural factors associated with fear of litigation as a driver for the increased use of caesarean sections: a scoping review

Do maternal characteristics influence maternal–fetal medicine physicians’ willingness to intervene when managing periviable deliveries?

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