Tuesday, April 26, 2011

A Convenient Cesarean?

Scheduling your cesarean
Today I came across a question that had been posted on a website for birth doulas to answer 'yes or no' to, and it struck me (as it always does when I see maternal request cesareans being discussed in this context) how irrelevant and uninformed it is:

"Should women be able to choose elective cesarean for convenience?"

Of course they shouldn't.

But the vast majority of women who request a planned cesarean birth are NOT doing so out of convenience, and even those who do cite convenience when asked, it's usually only as a secondary or associated benefit of surgery - not the primary one. Concern for their baby's health and protection against possible damage to their own bodies are far more important to them than convenience - as is an aversion to or fear of the natural birth process.

Furthermore, this focus on debating 'cesarean convenience' insults the intelligence and ethical standing of the many doctors who support maternal request. Certainly, there will be cases of women and doctors who schedule cesarean surgery in and around busy diaries, but it is very well established in medical studies that cesareans should not be carried out before 39+ weeks' gestation unless there is a specific medical or obstetrical reason for doing so, and again, the vast majority of doctors will abide by this.

Therefore, if you're going to vote on or discuss the clearly controversial issue of maternal request cesareans, at least word the question in a way that doesn't leave the author of this blog wanting to vote 'no' to something that - if worded correctly - I would normally find myself answering 'absolutely, yes!' to.

For example:

"Should a woman planing a small family be able to make an informed decision to choose a prophylactic elective cesarean at 39+ weeks' gestation?"


1 comment:

Anonymous said...

I haven't had the time to truly look at all the resources on your blog, so you might have discussed this before.

I just want to encourage you to make your readers, especially those that want more than one or two children, aware of the risks of multiple cesareans. The risk of placenta accreta climb, which is normally fertility-ending and sometimes life-ending.

Mrs. B, mom of 6 (4 by cesarean, 2 by vaginal birth)