Background Babies to women eligible for trial of labor after a cesarean (TOLAC) are sometimes delivered by cesarean section (CS). To obtain clinicians’ attitudes and beliefs about TOLAC, this study was designed to investigate the views of clinicians when advising TOLAC-eligible pregnant women about TOLAC, and to explore their reasons in favor of or against TOLAC. Methods Interviews were carried out individually (face-to-face) with clinicians using a specially designed questionnaire to collect data from obstetricians in the Western Region of Saudi. Regression analysis was used as appropriate. Results Among the 183 obstetricians included in the current study, approximately 79.2% were against offering TOLAC. However, most of the physicians (89.1%) were in favor of offering TOLAC to patients who had had a successful vaginal birth after CS. significant associations were found between physicians’ opposition to TOLAC and medical and most non-medical factors. Conclusion Clinicians should recognize that the critical role they play in the delivery decision-making process and in boosting women’s confidence in TOLAC may be key to increasing the rate of TOLAC.

Abstract Objectives: To investigate the frequency of job satisfaction, burnout and ethics among physicians across specialties with varied levels of experience and seniority, in hospitals in Makkah, Saudi Arabia. Methods: From April-May 2016, job satisfaction, burnout and ethics were assessed in 136 physicians across specialties from six government hospitals in Makkah. Data collection was via a self-administered questionnaire. SPSS was used to obtain the likelihood ratio chi-square for all categorical bivariate statistical analyses. P value <0.05 was considered significant. Results: A total of 136 physicians participated in the study. Sixty-nine percent physicians were male and 31% were female. Medical specialties varied between genders. There was no significant difference by gender, in job satisfaction among physicians (p-value 0.99). However, a high level of burnout was statistically significant among physicians (51%, p-value <0.0001) and the level of burnout was significantly higher among physicians willing to change their specialty compared to those willing to repeat it (50% vs. 24%, p-value 0.02). Physicians dissatisfied with their salary had double the scores of ethics compared to satisfied physicians. Female physicians were better at resolving ethical dilemmas. Conclusion: This study provided the first evidence of high frequency of burnout and career choice regret among physicians working in Makkah, Saudi Arabia. Preventing physician burnout not only improves the quality of healthcare but also ensures patient safety. Keywords: Physician satisfaction, ethics, burnout, work stress, loss of enthusiasm