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Ethics and "cesarean delivery on maternal demand".
Stephen R Latham1, Errol R Norwitz
1Interdisciplinary Center for Bioethics, Yale University, New Haven, CT 06520-8293, USA. Stephen.Latham@Yale.edu
Seminars in Perinatology
|November 17, 2009
Summary
Physicians should avoid routinely offering elective cesarean deliveries. If a patient requests a cesarean delivery, doctors must discuss its risks and benefits thoroughly before proceeding.
Area of Science:
- Obstetrics and Gynecology
- Medical Ethics
Background:
- Ongoing debate exists regarding cesarean delivery solely based on maternal request.
- Definitional ambiguities complicate the discussion around elective cesareans and maternal demand.
Purpose of the Study:
- To clarify terminology and ethical considerations surrounding cesarean delivery on maternal demand.
- To provide guidance on physician offers of elective cesarean delivery.
Main Methods:
- Analysis of ethical and practical considerations in cesarean delivery decision-making.
- Review of risk-benefit profiles for planned elective cesareans.
Main Results:
- Planned elective cesareans and "cesarean delivery on maternal demand" share similar risk profiles.
- Not all planned elective cesareans stem directly from maternal demand.
- Routine offers of elective cesareans are not advised.
Conclusions:
- Neutral language is recommended when discussing cesarean delivery decision-making.
- Physicians should refrain from routinely offering elective cesareans.
- Elective cesareans may be provided only after a comprehensive risk-benefit discussion initiated by the patient.
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