Cesarean section is a fairly common surgical procedure to extract the baby in our environment. 26 percent of deliveries in Spain are by caesarean section, double that recommended by the WHO for whom the “ideal” rate of caesarean section is between 10 and 15 percent.
Cesarean section may be necessary when vaginal delivery poses a risk to the mother or child, as long as there is a justifying medical reason, such as in case of prolonged labor, fetal distress or when the baby is misplaced. But what happens when it is the mother herself who expressly requests to give birth by cesarean section because it is her wish ?
This is what is known as “cesarean section on demand” , “cesarean section on demand” or “cesarean section at the patient’s choice”, a fairly common phenomenon among some celebrities, women who have had a previous vaginal birth that has been traumatic, or women afraid of childbirth.
According to a 2017 study, the reasons that lead women to request a caesarean section is the combination of fear of pain and unpredictability.
Vaginal delivery is always the best option
It is important to know that cesarean section is not a panacea, and that it is not an alternative to vaginal delivery, but is performed when it is not possible and should be limited to those cases in which there really is a need for its performance. Vaginal delivery is the most recommended, the safest and always the best option, since the risks of undergoing a cesarean section are greater than those of a vaginal delivery .
It should not be forgotten that although it is very frequent, it is still a surgical intervention, with the risks of any operation. Among other risks, cesarean section presents an increased risk of bleeding and uterine atony, tears in the uterine wall, injuries to pelvic organs (bladder, intestine), in addition to possible anesthetic complications. Likewise, it has postoperative complications such as an increased risk of abdominal infections and of the surgical wound itself. Not to mention the longer recovery and wound discomfort after the cesarean section.
Assuming that all the conditions for a vaginal delivery are met but the mother rejects this way of giving birth, an ethical debate is opened. Cesarean section at the mother’s request must be evaluated by the medical team taking into account each particular case.
It is clear that a woman has the right to choose her way of giving birth, but it is also true that the patient’s decision may entail real risks for her and for her child. Therefore, the doctor should try to persuade her of these risks and get her to change her mind.
If the woman persists, the obstetrician must ensure that she is informed and if her reasons are based on this information, “C-section would be ethically permissible.”
According to this medical article, caesarean section at the request of the pregnant woman should be considered and respected taking into account the principle of autonomy of the pregnant woman , but the doctor has the obligation to fully explain the advantages and disadvantages in her specific case.
If an elective cesarean section is performed, it should be scheduled from the 39th week of gestation to reduce the risk of fetal respiratory morbidity.
In Babies and more | Step-by-step cesarean section, what does it feel like ?: my personal experience from the time you enter the operating room until the stitches are removed
