Are decisions about cesarean deliveries affected by litigation fears or economic expectations?

Aim: Annually, approximately 20 million pregnant women undergo cesarean sections worldwide. However, a global trend of increasing cesarean section rates has been observed. The objective of this study is to evaluate which factors affect the decision of physicians to perform cesarean sections, with the exception of the actual indications for such procedures. Material and Methods: Data were collected using questionnaires that were delivered through the internet and telephone. The questionnaires consisted of 24 questions, including age, year of professional experience, institution, working conditions, and economic expectations. Results: The present study included 327 clinicians. The findings indicated that clinicians demonstrated a higher degree of acceptance of pregnant women's preferences regarding the type of birth, particularly among physicians working in the private sector (62.9% vs. 21.2%, p 0.05). Conclusion: Pregnancy preferences have been demonstrated to exert an active role in changing rates of birth type in the private sector. On the other hand, concerns related to forensic medicine may exert an equal influence on the change in cesarean rates across both the private and public sectors.