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May 2008 · Vol. 20, No. 05

“Doctor, I want a C-section.” How should you respond?

Is she motivated by a fear of childbirth or a true wish for C-section? Here’s how to identify candidates.


Fast Track

In the United States in 2004, 18% of births, or nearly 750,000, involved primary C-section

NIH panel: With planned C-section, the frequency of postpartum hemorrhage is lower than with combined planned vaginal delivery and unplanned C-section

There is a risk of iatrogenic prematurity with scheduled C-section

C-section protected against intracranial hemorrhage, neonatal asphyxia, encephalopathy, birth injury, and neonatal infection

Women who opt for elective cesarean for their first delivery may be committing themselves to C-section with subsequent deliveries

In some states, a patient who elects a scheduled C-section at term without obstetric indications may be required to pay for her obstetric care

IN THIS ARTICLE

Caren  M.  Stalburg,  MD, MA

Dr. Stalburg is Clinical Assistant Professor, Department of Obstetrics and Gynecology and Medical Education, at the University of Michigan Health System in Ann Arbor.

The author reports no financial relationships relevant to this article.

In general, when a patient inquires about elective primary C-section, it is best to consider the “6 C’s of elective cesarean” in a careful discussion with her. That approach entails consideration of the following:

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