Second opinions reduce C/S rate-slightly

About 90% of the women in each group looked favorably upon their physicians consulting another professional about their case. Most women in both groups (87.9% in the second opinion group vs. 87% of the single opinion group) said they would return to the hospital to deliver another baby or would recommend the hospital to other women giving birth (91.2% vs. 93.2%, respectively).

And before the final results became available, more than half of the participating physicians (54%) judged the mandatory second opinion procedure to be "effective" or "very effective" at reducing the C/S rate. Eighty-seven percent thought the strategy would be feasible in public hospitals; 41% thought so with regard to private hospitals. Ninety-one percent said they'd recommend the strategy in public hospitals, and 65% said they'd do so for private hospitals.

Some experts question whether 22 fewer procedures per 1,000 deliveries justifies the use of mandatory second opinions, while others argue that any step in the direction of WHO's target rate of a 15% reduction in C-sections is worth trying.

Althabe F, Belizán JM, Villar J, et al. Mandatory second opinion to reduce rates of unnecessary caesarean sections in Latin America: A cluster randomised controlled trial. Lancet. 2004;363:1934-1940.