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To the Editor.—
The recent article by Phillips et al (1982;248:1082) addressed the important issue of physician bias in cesarean sections. Several years ago, I analyzed the records from a hospital in northern California with a large obstetric service and found that cesarean sections done for dystocia occurred at certain times of the day (between 4:30 to 7 PM and 9:30 to 10:30 PM) and hardly any at other times (between 1:30 to 5:30 AM). It seemed to me that these times of performing a cesarean section conform to the physicians and staff schedules, that they were after office hours or before a change of shift, and that they were hardly ever in the early hours of the morning. Instead of looking at the days of the week, I suggest that Phillips et al should have looked at the times of the day when cesarean sections were done to answer
Goodlin R. Physician Bias in Cesarean Section. JAMA. 1983;249(8):1005. doi:10.1001/jama.1983.03330320013011