Obstetrician changes his mind about Maternal Request

Admiration and respect. These are the words I would use to describe my feelings towards Dr. Silvio Aladje, an OBGYN and maternal fetal medicine specialist at Michigan State University in the U.S.  In his blog posted yesterday, 'Caesareans Section On Demand', he describes how, after reading our book, he has changed his position in the debate over maternal request caesareans. I don't admire and respect him because he has changed his mind, but rather because he is willing to say so publicly (which not everyone would be brave enough or gracious enough to do) and because his actions are one step closer towards wider recognition that maternal request caesarean is a legitimate birth plan.

Dr. Silvio writes that his position used to be, "there are two modes of delivery: 'vaginal' and 'cesarean section'. When needed, cesarean sections should be performed without hesitation, and, when not, they shouldn’t." He also says, "until very recently I was in the group of physicians who would have been hard pressed to perform a cesarean section without a medical indication."

But he concludes thus:

"I was once told that politicians change their positions because it may be convenient; we, physicians, change our ideas because our learning never stops. Yes, I have now changed my mind. The time has come for us to support women making an informed decision regarding how they want to be delivered. They have their choice for a vaginal delivery experience or a birth by cesarean section, without medical indications. It should be a decision between the pregnant woman and her physician, after a thorough evaluation of the patient’s intrinsic risks based on her medical history or circumstances, and not based on our own bias on the subject."

Thank you, Dr. Silvio.