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Generation of Maternal Mutants Using zpc:cas9 Knock-in Zebrafish
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Elective cesarean delivery on maternal request.

Jeffrey Ecker1

  • 1Harvard Medical School, and Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA. jecker@partners.org

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Cesarean delivery on maternal request (CDMR) does not reduce health risks for mothers or infants. Decisions about CDMR should consider a woman's complete reproductive plans.

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Area of Science:

  • Maternal-Fetal Medicine
  • Reproductive Health Policy
  • Surgical Obstetrics

Background:

  • Some pregnant women request cesarean delivery without medical indication.
  • Cesarean delivery on maternal request (CDMR) is a growing consideration in obstetric practice.

Observation:

  • The prevalence of CDMR in the U.S. is uncertain but likely under 3% of deliveries.
  • Obstetricians frequently encounter requests for CDMR.
  • CDMR may have short-term benefits like reduced hemorrhage but increased neonatal respiratory risks.

Findings:

  • CDMR is associated with higher neonatal respiratory morbidity compared to vaginal delivery.
  • Long-term adverse effects of CDMR may appear in subsequent pregnancies.
  • Repeat cesarean births increase risks of complications, including placenta accreta and hysterectomy.

Implications:

  • CDMR is not expected to improve maternal or infant health outcomes.
  • Counseling for CDMR must incorporate the patient's full reproductive trajectory.
  • Informed decision-making regarding CDMR requires comprehensive discussion of risks and future fertility.