Do physicians and their relatives have a decreased rate of cesarean section? A 4-year population-based study in Taiwan

Background: The increased rate of cesarean deliveries may be partly due to a lack of consumer knowledge. Assuming that physicians and their relatives are well informed of the risks and benefits associated with the different methods of delivery, our goal was to compare cesarean rates between female physicians, female relatives of physicians, and women with high socioeconomic status in Taiwan. Methods: Two subgroups of 588 female physicians and 5,021 relatives of physicians aged 20 to 50 years were compared with 93,737 pregnant women with a monthly wage $40,000 New Taiwan (Alf) dollars or more as identified in nationwide National Health Insurance databases of Taiwan from 2000 to 2003. Results: Female physicians (adjusted odds ratio 0.66; 95% CI 0.47, 0.93) and female relatives of physicians (adjusted odds ratio 0.84; 95% CI 0.74, 0.95) were significantly less likely to undergo a cesarean section than other high socioeconomic status women, adjusted for clinical and nonclinical factors. Conclusions: In this study, the cesarean delivery rate was lower among women who may have greater access to medical knowledge. However, the lower rates observed among female physicians and physician relatives in Taiwan are still considerably higher than the national averages of many countries. This finding suggests that other than information, practice patterns, and social and cultural milieu may play a role.