Doctor: Offer cesarean to women 40 years +

In a letter to the editor published in June's J Obstet Gynaecol Can, Dr. Venu Jain argues that with the increasing numbers of women giving birth at older ages, and the fact that they are more likely to experience obstetric problems, doctors should consider discussing and offering them an elective cesarean birth.

In 'Elective Caesarean Section for the Mature Nullipara', Jain concludes: "The foregoing discussion leads to the question: in nulliparous women aged 40 and over, given the risks associated with a trial of vaginal delivery, should an elective Caesarean section be offered?4 On the basis of current evidence, it appears that not only may the risk of intrapartum/ postpartum maternal (and neonatal) complications be lower but also that such an approach has the potential to reduce the long-term maternal morbidity related to obstetric trauma such as urinary incontinence and pelvic organ prolapse. If elective Caesarean is not offered, would informed consent for trial of a vaginal delivery be prudent in the current medico-legal milieu?"

If you're an older mum, and haven't yet decided on your birth plan, you might want to read Dr. Jain's letter in full here.