My letter, published in the British Medical Journal on 22nd July 2010, was in response to the publication: 'Time of birth and risk of neonatal death at term: retrospective cohort study', by Dharmintra Pasupathy, Angela M Wood, Jill P Pell, Michael Fleming and Gordon C S Smith.
"The unpredictability of planned vaginal delivery or a trial of labor (i.e. the possibility of assisted delivery and/or emergency surgery) is one of the reasons often cited by women who decide to deliver their babies by planned cesarean.
This study illustrates that the unpredictable nature of the delivery outcome itself (and any associated morbidity or mortality) is not the only risk these women seek to avoid. The unpredictability of the quality of care available at different hours of the day and night when women arrive at hospital in labor is another risk they do not wish to take, especially when this might impede the safe and healthy arrival of their baby.
The 'convenience' of scheduling a time and date for maternal request cesarean delivery is sometimes criticized as an irresponsible benefit of surgery, but when looked at from the perspective of this study (and others like it), there is clearly a legitimate benefit involved in knowing exactly who will deliver your baby and when, and it has nothing whatsoever to do with convenience."