To determine whether patient‐perceived pressure from clinicians for labor induction or cesarean delivery is significantly associated with having these procedures.
, a nationally representative survey of women 18–45 years who delivered a singleton infant in a U.S. hospital July 2011–June 2012 ( = 2,400).
Multivariate logistic regression analysis of factors associated with perceived pressure and estimation of odds of induction and cesarean given perceived pressure.
Overall, 14.8 percent of respondents perceived pressure from a clinician for labor induction and 13.3 percent for cesarean delivery. Women who perceived pressure for labor induction had higher odds of induction overall (adjusted odds ratio [a]: 3.51; 95 percent confidence interval : 2.5–5.0) and without medical reason (a: 2.13; 95 percent : 1.3–3.4) compared with women who did not perceive pressure. Those perceiving pressure for cesarean delivery had higher odds of cesarean overall (a: 5.17; 95 percent : 3.2–8.4), without medical reason (a: 6.13; 95 percent : 3.4–11.1), and unplanned cesarean (a: 6.70; 95 percent : 4.0–11.3).
Patient‐perceived pressure from clinicians significantly predicts labor induction and cesarean delivery. Efforts to reduce provider–patient miscommunication and minimize potentially unnecessary procedures may be warranted.
Data Sources/Study Setting