[The pregnant woman's request for caesarean section from a medical point of view]

The wish to be delivered by caesarean section for personal reasons without medical indication must be discussed from both the medical point of view and in view of the legal position of the mother and her child. Today the mortality/lethality risk in primarily indicated and performed caesarean sections is not substantially higher than with vaginal deliveries. What is important is the aspect of the "consequences of caesarean section on following pregnancies". Besides the risk of scar rupture, the drastic increase in the incidence of abnormal placental detachment (placenta accreta/increta/percreta) and placenta praevia in the following pregnancy is of importance. On the other hand, this risk must be weighed against the fetal risk from vaginal delivery in terms of intrauterine death and encephalopathy caused by intrapartum hypoxia as well as cerebral paralysis amounting to 1/500. Pelvic floor damage after vaginal delivery can probably be reduced but not necessarily avoided by primary caesarean section.