Elective C-Sections on the Rise

The Ethics of Elective Cesareans

Because of the medical risks inherent in major abdominal surgery, such as infection and excessive bleeding, the American College of Obstetricians and Gynecologists (ACOG) has traditionally discouraged doctors from performing Cesareans that are not medically indicated. Yet last year ACOG determined that there is no single "correct" opinion on elective C-sections because of the lack of conclusive data comparing the long-term benefits of vaginal delivery and C-section.

ACOG has deemed it ethical for doctors to deliver a baby by C-section upon the request of the mother even if she faces no apparent risks from labor and vaginal delivery. In Surgery and Patient Choice: The Ethics of Decision Making, ACOG states, "in the case of an elective cesarean delivery, if the physician believes that Cesarean delivery promotes the overall health and welfare of the woman and her fetus more than does vaginal birth, then he or she is ethically justified in performing a Cesarean delivery." Similarly, it states that if the physician believes that performing a Cesarean would be detrimental to the overall health and welfare of the woman and her fetus, he or she is also ethically obliged to refrain from performing the surgery.

ACOG cautions doctors and patients that evidence to support the benefit of patient-choice C-section is still incomplete, and that there are currently no extensive morbidity and mortality data to compare elective C-section deliveries with vaginal deliveries in healthy women.

Whether or not you feel that an elective Cesarean is the best course of action for you, it is important that you do your research before making the decision to give birth surgically. Consider your doctor's advice, seek prenatal education relevant to childbirth and recovery, and make an educated decision based on what you feel is best for you and your child.