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Patient-Choice Vaginal Delivery?

¹ Departments of Family and Community Medicine and Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM
² Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Penn

CORRESPONDING AUTHOR: Lawrence M. Leeman, MD, Department of Family and Community Medicine, 2400 Tucker NE, 3rd Floor, Albuquerque, NM 87106, lleeman{at}salud.unm.edu

ABSTRACT

Patient-choice cesarean delivery is increasing in the United States. The American College of Obstetricians and Gynecologists supports this option, citing ethical premises of autonomy and informed consent, despite a lack of evidence for its safety. This increase in patient-choice cesarean delivery occurs during a time when women with a breech-presenting fetus or a previous cesarean section have fewer choices as to vaginal birth. Patient-choice cesarean delivery may become widely disseminated before the potential risks to women and their children have been well analyzed. The growing pressure for cesarean delivery in the absence of a medical indication may ultimately result in a decrease of women’s childbirth options. Advocacy of patient-choice requires preserving vaginal birth options as well as cesarean delivery.

Key Words: Cesarean section • surgical procedures, elective • patient choice • vaginal birth after cesarean • breech presentation • pregnancy • childbirth

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