Orientierung zwischen Nutzen und Nutzerinnen - Klinikärztliche Entscheidungsfindungen und Entscheidungskontextualitäten bei einem Kaiserschnitt auf Wunsch

Augmented CS rates are also the result of a new trend in obstetrics towards an increasing acceptance of by choice elective sections by pregnant women and obstetricians. The focus of (health) scientific analysis has shifted to paramedical influences and a need for more research into obstetricians decision-making processes for elective CS by choice is shown. This study examines the interactions between obstetricians and pregnant women who express a wish for elective CS. It is based on 18 expert interviews with obstetric consultants in Germany (county of Bremen). The interaction between doctor and patient is as important as medical reasons for the decision-making process. Limitations in obstetricians decision-making processes seem to be influenced by economic shortcomings in the health service, a deficit in proper obstetrician-GP communication structures and the discussion around the authoritative patient in control of decisions . Attempts at solving these paramedical influences are either with individual strategies that tend to shift responsibilities around within the hierarchic structures of the health system, or with an interdisciplinary attempt at finding a collective decision or solution. The cooperation of professionals in university and clinical education, obstetrics, politics and health sciences is needed to produce a change.