Use and misuse of the term "elective" in obstetrics

The term "elective" is commonly used in obstetrics. We performed an electronic search of MEDLINE database using the terms "elective" and "obstetrics," which provided 2,208 publications. We found "elective" was more often used in relation to surgical interventions (eg, cesarean delivery, cerclage) and medical procedures (labor induction) rather than diagnostic procedures. Our review indicates the term lacks the necessary scientific specificity when used to modify procedures such as cerclage, cesarean delivery, timing of delivery, episiotomy, hysterectomy, labor induction, preterm delivery, termination of pregnancy, and ultrasonography. The lack of specificity of the term suggests the most reasonable and prudent course of action is to not use it, but rather to document the specific indication (whether medical or non-medical) for the intervention or procedure (eg, "cesarean delivery on maternal request," "history-indicated cerclage," "induction for preeclampsia"). We propose that the term "elective" should be eliminated from the vocabulary of obstetric practice.