Some Patients Misinterpret Delivery Advice as Pressure

November 15, 2014

Women who perceive being pressured by clinicians to have a labor induction or c-section are more likely to undergo the intervention even if medically unnecessary.

Patient-perceived pressure from health care providers significantly predicts labor induction and cesarean delivery, a new study reports.

Using data from Listening to Mothers III, a nationally representative survey of 2400 women aged 18 to 45 years who delivered a singleton infant in a US hospital between July 2011 and June 2012, researchers analyzed factors associated with perceived pressure and the likelihood of induction and c-section based on perceived pressure.

What they found was that nearly 14.8% of respondents reported feeling pressured to have a labor induction, and 13.3% felt pressured to have a c-section.

Further analysis revealed that women who felt pressured to be induced were 3.5 times more likely to have an induction and more than twice as likely to have an induction for no medical reason than women who didn't feel pressured. Similarly, women who perceived pressure to have a c-section were more than 5 times more likely to have a cesarean overall, more than 6 times more likely to have a c-section with no medical basis, and nearly 7 times more likely to have an unplanned cesarean.

These findings reveal a need to reduce miscommunication between patients and their providers and more efforts to minimize potentially unnecessary procedures, concluded the researchers.

“In the majority of cases, if you spend enough time explaining to patients what’s going on, why it’s going on, and what type of delivery is the best option, then it really makes the news more easy to take,” said Erin Myers, MD, an OB/GYN at Greater Baltimore Medical Center, to Health Behavior News Service, part of the Center for Advancing Health. “The problem with the health care system is that we don’t have hours to talk with patients, so we are forced to explain complicated medical decisions in a limited time period.”

Do you agree that miscommunication related to not enough time with patients is likely the basis for some patients feeling this way?

(We welcome your thoughts in the Comment section below.)