• The Girlfriend's Approach To Gynecology
    The Girlfriend's Approach To Gynecology
    "Gynecologists with simple answers to women's health concerns".
  • Latest Articles
    Latest Articles
    See the latest blogs here.
  • Gyno Myths
    Gyno Myths
    Clearing up some of the common misconceptions in women's health.
  • Discussions on Women's Health Issues
    Discussions on Women's Health Issues
    A forum where you can post your comments on related health issues.

View All Articles

Do you like our site?

This user has reached the maximum allowable queries against Twitter's API for the hour.

Cesarean Section on 'Maternal Request'? Be Sure to Understand Your Risks


In modern obstetrics, there is a growing trend in expecting mothers’ request for ‘elective’ Cesarean section (‘Cesarean Section on Maternal Request’.)  This ‘elective’ cesarean delivery, is a maternal request for Cesarean section delivery, in the absence of any maternal or fetal need (nor medical indication) for Cesarean section birth.  (This particular ‘request’ for Cesarean section refers to a maternal request for a first-time Cesarean delivery… not a request for a repeat Cesarean birth, as in the case of a mother with previous Cesarean Section deliveries.)  In the U.S. 2.5% of births are performed by Cesarean section for this request.  In my experience, concern and anxiety regarding pain in labor seem to represent the most common reason for this request.

The most common medically indicated reasons for a primary (first time) Cesarean Section are:

  1. Failure to progress in labor – when in active labor, the progression of cervical dilation is halted.
  2. Concerns regarding  the fetal heart rate – fetal heart rate patterns that could represent present or pending concerns for fetal stress in further laboring.
  3. Fetal malpresentation – fetal  positions other than head-down (vertex), most commonly breech.

For patients considering a Cesarean Section on request, whether for reasons of convenience, fear of the pain or process of labor, or a previous ‘bad’ experience in labor, the risks versus benefits of a vaginal delivery over a Cesarean section must be considered.   The potential benefits of a vaginal delivery over a Cesarean section include:  shorter hospital stays, lowered infection rates, fewer anesthetic complications, and lowered surgical complication rates.

A Cesarean section is still a surgery, where the risks of surgical complication (such as bleeding, infection, and injury to internal organs) are overall, still higher than with a vaginal delivery.  Increased surgical risks aside, we should also not forget the potential risks posed to a subsequent pregnancy because of a history of a previous Cesarean section, those including:  the risks of uterine rupture, placenta previa, bowel and bladder injury, and surgical complications that could increase  the risk for hysterectomy at the time of a subsequent Cesarean section.  Because the obstetrical and surgical risks increase with each subsequent Cesarean section performed, a woman’s desire for several children/planned family size, should be a recognized factor in counseling women who may be considering Cesarean section on request.

If fear of pain in labor is what’s motivating you to consider a Cesarean section on request, speak with your Obstetrical care provider to learn more about your options for pain management in labor.  If a Cesarean section upon request still remains your desire, make sure you understand your risks.


Here is more information from ACOG on Cesarean Section on Maternal Request: http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Cesarean_Delivery_on_Maternal_Request


Suzanne Hall, MD (@drsuzyyhall)

Eastside Gynecology Obstetrics, PC

Offices located in Roseville, Grosse Pointe, Macomb, Rochester MI

About the author



Please login first to submit your comment

Join the Cause

If you have expertise in the health profession and would like to join us please Click Here

Stay In The Loop

Stay in touch with new articles, posts, stories important happenings at Gyno Groupie! Join the mailing list today! Click Here