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Should doctors perform an elective caesarean section on request?

K Devendra1, S Arulkumaran

  • 1Department of Obstetrics and Gynaecology, St. George's Hospital Medical School, London, UK.

Annals of the Academy of Medicine, Singapore
|November 25, 2003
PubMed
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Maternal request for caesarean sections is increasing due to various factors. However, these procedures carry higher risks than vaginal births and do not guarantee reduced fetal mortality, raising ethical concerns.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Bioethics

Background:

  • Rising incidence of caesarean sections requested without clear medical indications.
  • Contributing factors include social, cultural, and psychological influences.
  • Caesarean sections carry higher mortality and morbidity risks than vaginal deliveries, even when elective.

Purpose of the Study:

  • To analyze the risks and benefits of caesarean sections performed on maternal request.
  • To explore the ethical and legal complexities surrounding non-medically indicated caesarean births.
  • To provide guidance for healthcare professionals managing such requests.

Main Methods:

  • Review of existing literature on caesarean section indications, risks, and outcomes.
Keywords:
Health Care and Public Health

Related Experiment Videos

  • Analysis of ethical principles related to patient autonomy and societal interests.
  • Discussion of clinical management strategies for maternal requests.

    • Main Results:

    • Elective caesarean sections are associated with increased maternal and fetal risks compared to vaginal delivery.
    • Pelvic floor damage can occur irrespective of delivery method.
    • Universal elective caesarean sections are unlikely to decrease late intrauterine deaths and may introduce iatrogenic risks.

    Conclusions:

    • Maternal request caesarean sections present complex ethical and legal challenges regarding informed consent.
    • The rights of the individual must be balanced against societal interests and healthcare resource allocation.
    • Obstetricians should provide unbiased information, explore underlying reasons for requests, and consider individualized labor management or second opinions.