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Created on : 23 Feb 2006
Modified on : 01 Dec 2007

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Bibliographical entry (without author) :

The Problem with “Maternal Request” Cesarean

Author(s) :

Lamaze International

Year of publication :

2006

URL(s) :

http://www.lamaze.org/institute/about/statements.a…

Résumé (français)  :

Abstract (English)  :

The concept of “maternal request” cesarean presents a number of serious problems:

• Elective cesarean surgeries, that is, surgeries without medical indication, should not be equated with “patient” or “maternal choice” cesareans because they could equally well represent “physician choice“ cesareans (Kalish 2004).
• We do not know to what extent women freely make an informed choice when they choose to have a cesarean. Studies of maternal preference for cesarean fail to assess whether women were told of the potential harms of cesarean surgery, whether alternatives were discussed, the accuracy of the information women were given, and what opinion the care provider held (Gamble 2000). What women hear from obstetricians powerfully influences what they think. Some obstetricians think so little of the risks, pain, and recovery of cesarean surgery that they feel that “convenience,” “certainty of delivering practitioner,” and “[labor] pain” justify performing this major operation on healthy women (Wax 2005).
• Requesting a cesarean because of fear of labor is not “maternal choice” in the strict sense of the term. Anxiety severe enough to prefer major surgery over a normal, physiologic process is a psychological condition deserving of investigation and treatment. For example, if the concern is labor pain, a planned epidural may be a solution. Prenatal counseling, doula care (continuous labor support by a skilled or experienced woman), or both may reduce abnormal levels of anxiety, and so forth. Only after alternatives have been explored and rejected should elective surgery be considered.

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Resumen (español)  :

Full text (private) :

Comments :

Argument (français) :

Argument (English):

Argumento (português):

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Keywords :

➡ c-section/caesarean ; vaginal birth after caesarean

Author of this record :

Bernard Bel — 23 Feb 2006