The American College of Obstetricians and Gynecologists reaffirmed their Committee Opinion originally released in 2007 of cesarean delivery on maternal request in a publication released online today. The opinion was on the subject of primary cesarean delivery on maternal request with no medical indications for a cesarean delivery–in other words, a first time cesarean delivery of a mother who desires a cesarean absent medical necessity. The recommendation is that cesarean delivery not be performed on mothers less than 39 weeks of gestation (unless there has been documentation of lung maturity in the fetus), that the mother not be primarily motivated by a fear of lack of adequate pain management options, and also that a primary cesarean delivery absent medical indication not be performed on a woman who desires several children, as the risk of placental complications and hysterectomy rises with each subsequent cesarean delivery. The opinion also recommended that a woman’s specific risk factors be considered when she desires a primary cesarean delivery, including “…age, body mass index, accuracy of estimated gestational age, reproductive plans, personal values, and cultural context.” The opinion’s abstract noted that one possible benefit of cesarean delivery “…is a decreased risk of hemorrhage for the mother”, but that “…potential risks of cesarean delivery on maternal request include longer maternal hospital stay, an increased risk of respiratory problems for the baby, and greater complications in subsequent pregnancies, including uterine rupture and placental implantation problems.”
To read the full release, click here. Were any of these considerations discussed with you when your doctor recommended a cesarean delivery, particularly your desired family size? When did the discussion of a cesarean delivery come up in discussions with your care provider?