Physician Bias in Cesarean Section

To the Editor.—  Phillips et al assumed that physicians on call might want more time off during weekends and may resort to abdominal deliveries sooner. Thus, they studied the incidence of the various indications for cesarean delivery and compared weekends and weekdays. They did not find any substantial difference between the deliveries on weekends and weekdays.I propose that physicians who are on call for weekends do not usually plan any other activities for those days and that this may have been the reason for the authors' findings. However, most persons who have a full-day schedule ahead prefer to rest after midnight, and this may be a more sensitive tool to detect physician bias on the decision-making process about abdominal deliveries. I assume that obstetric events (vaginal and nonelective abdominal deliveries) should have an even distribution during the 24 hours. However, when I reviewed these data in a community hospital