CAESAREAN SECTION ON REQUEST

Advances in surgical techniques, anaesthesia, thromboprophylaxis, blood transfusion, antibiotic therapy, and improved general health have changed Caesarean section (CS) from a procedure associated with considerable risk of morbidity and mortality to mother and/or fetus to one with little risk. Although CS is performed for obstetric indications, the threshold is lower, including CS on request, leading to a trend of rising CS rates. A main focus of debate is CS request by women who subjectively perceive benefit from an elective CS. The issues involved are complicated and the implications far-reaching. When risks, benefits, and costs are assessed, the perceived advantage of vaginal delivery over elective CS may be diminished or eliminated and decisions on the mode of delivery may be based on preferences rather than statistics. In this article, we outline some of the arguments for and against CS on request and the opinion of the Ethics Committee of the International Federation of Obstetricians and Gynaecologists (FIGO).