Is patient-choice primary cesarean rational?

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May 2006 · Vol. 18, No. 5

Is patient-choice primary cesarean rational?

If—and only if—the patient brings up the subject, says NIH, go ahead and counsel her on risks and benefits

Fast Track

After the third cesarean, there is minimal protection from urinary incontinence

As the cesarean rate has increased:

Placenta accreta has increased 10-fold
Cerebral palsy incidence has not declined

Revisit the subject periodically during antenatal care, laying out the pros and cons of cesarean vs vaginal delivery

IN THIS ARTICLE

Maternal-fetal risks, by mode of delivery

BREAKING NEWS

NIH asks … and ObGyns and patients answer emphatically
by JANELLE YATES
Will cesarean surge subside?

Geeta Sharma, MD

Assistant Professor, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Weill Cornell University Medical Center, New York City

CASE Is her request reasonable?

A 40-year-old primigravid woman presents for her first prenatal visit and asks for cesarean delivery. She explains that she has “waited all her life” for this baby and does not want to risk any harm to the infant during childbirth. She also admits that she is uncomfortable with the unpredictability of childbirth.

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