Caesarean Section on Maternal Request

Abstract

Caesarean section on maternal request (CSMR) is performed in the absence of a standard medical/obstetrical indication in order to avoid vaginal delivery. Globally, there has been an upsurge in CS delivery, which necessitates the urgency to address maternal and foetal health implications, and long-term repercussions. Conceptually, the chapter aims to explore the determinants of increased CSMR, highlight its potential risks and benefits, and discuss the ethical, medico-legal concerns. Findings indicate that medical, psychological, psychosocial, economical, social and cultural determinants might serve as some of the potential influencing factors owing to this serious healthcare concern. Although CSMR has been linked to certain beneficial outcomes (e.g. reduced urinary incontinence and pelvic organ prolapse, reduced rate of PTSD and depression, and lesser intrapartum complications), it still imposes serious maternal (e.g. post-partum haemorrhage and infection, visceral damage, placenta accrete, placental abruption and complications in future pregnancy) and foetal adverse outcomes (stillbirth, asphyxia, respiratory distress and other pulmonary infections). Hence, future approaches and interventions should be directed towards mitigating clinically unrequired CS procedures due to medical malpractices, lack of awareness in women and the underlying determinants of elective CS.