CHOOSING CAESAREAN SECTION

Marsden Wagner

Published in The Lancet, vol 356, pp 1677-80, November 11, 2000

Introduction

“With a scheduled Caesarean section, you and your doctor have agreed to a time at which you will enter the hospital in a fairly calm and leisurely fashion, and he or she will extract your baby through a small slit at the top of your public hair. There are a lot or reasons to schedule a caesarean section------Other women elect to have a caesarean because they want to maintain the vaginal tone of a teenager, and their doctors find a medical explanation that will suit the insurance company.” (1)

This statement from a currently popular paperback book in the US illustrates the degree to which that society appears to condone women choosing CS (and doctors committing insurance fraud). Such a statement is reinforced when the incoming President of the American College of Obstetricians and Gynecologists, in a leading editorial by that organization promoting ‘patient choice cesarean’, calls this major abdominal surgical procedure “a life-enhancing operation”. (2)

Caesarean section (CS) is an essential surgical procedure which, when properly applied, can and has saved the lives of many women and babies around the world. So why not allow pregnant women the option to choose birth by CS?

Unfortunately giving women the option to choose (or even demand) a CS is not that simple. CS, even when elective and with no emergency, carries serious risks including an increased chance the woman will die and an increased chance the baby will have life-threatening conditions which may lead to death...

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