Specialty differences in primary cesarean section rates in a rural hospital.

To evaluate if physician specialty is a factor in determining whether cesarean sections are performed, a retrospective review of all obstetrical records was performed at a rural hospital in northeastern Kentucky. Review of 1522 patients who delivered between January 1, 1987, and June 30, 1989, showed that staff obstetricians had a 10.8% cesarean rate compared with 8.9% for family physicians. Analysis of the diagnoses that led to cesarean delivery showed no difference between the specialties for cesarean sections performed for fetal distress, preeclampsia, or other high-risk problems, but obstetricians had an increased cesarean section rate for cephalopelvic disproportion (10.7% of all deliveries vs 6.3% for family physicians, P less than 0.001). These results suggest that physician specialty may influence cesarean section rates, although other factors could also contribute to these results.