‘Maternal request’ caesarean sections and medical necessity

Abstract

Currently, many women who are expecting to give birth have no option but to attempt vaginal delivery, since access to elective planned caesarean sections (PCS) in the absence of what is deemed to constitute ‘clinical need’ is variable. In this paper, we argue that PCS should be routinely offered to women who are expecting to give birth, and that the risks and benefits of PCS as compared with planned vaginal delivery should be discussed with them. Currently, discussions of elective PCS arise in the context of what are called ‘Maternal Request Caesarean Sections’ (MRCS) and there is a good deal of support for the position that women who request PCS without clinical indication should be provided with them. Our argument goes further than support for acceding to requests for MRCS: we submit that healthcare practitioners caring for women with uncomplicated pregnancies have a positive duty to inform them of the option of PCS as opposed to assuming vaginal delivery as a default, and to provide (or arrange for the provision of) PCS if that is the woman's preferred manner of delivery.

Análise da incidência e indicações de cesáreas na Maternidade Escola de Valença/RJ

“…A decisão entre parto vaginal e cesáreo tem sido objeto de intenso debate na comunidade obstétrica, com um consenso emergente de que a preferência por cesáreas pode estar crescendo, apesar das recomendações para limitar cesáreas a indicações médicas claras (Elgzar, 2023;Brown, 2023;Comfort, 2023). A escolha obstétrica da via de parto impacta diretamente a frequência de partos vaginais futuros.…”

“…No entanto, os dados deste estudo na Maternidade Escola de Valença/RJ contradizem parcialmente essa tendência, mostrando uma distribuição quase equânime entre os métodos de parto. Este equilíbrio ressoa com a literatura que defende a decisão compartilhada entre a parturiente e o obstetra, levando em consideração tanto as condições maternas quanto fetais (Brown, 2023;Escobal, 2022).…”

Features of the Physiology of the Postpartum Period After Caesarean Section

“…The postpartum period is a critical, but often overlooked, period in the lives of new parents. According to the WHO, the majority of maternal and newborn deaths occur during this period, so proper management and care of parents and newborns is vitally important [11,12,13].…”

Justification of Features Rehabilitation Interventions During Pregnancy and the Postpartum Period

“…Зростання частоти КР також розглядається у зв'язку із змінами у суспільстві -фінансовими, соціальним, культурними [34,35,36]. Ці фактори, разом із суспільним уявленням про те, що КР процедура майже без ризиків, сприяють збільшенню кількості виконаних абдомінальних пологорозрішень [37,38].…”