Can you request a c-section?

A Look at the Elective Cesarean Request

Cesarean Birth with Parents Holding Baby
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There is a lot of discussion about the birth of a baby via elective cesarean, or c-section. Elective in this case means that there is not a medical reason for the mother or the baby or labor that would require a cesarean birth. Given that a c-section has risks for both the mother and baby, it is something that requires a conversation.

An elective c-section is generally not offered to women during their prenatal care.

As a patient you are allowed to ask any question that you want to ask. Though your doctor or midwife may refuse your request. They may want to talk to you in detail about why you want to have elective surgery to give birth and try to find a way to ease your concerns or fears.

Many times the concerns that women have about vaginal birth lead them to believe that a cesarean birth would be easier or safer for them or their babies. This is a chance to talk with their provider about why they want a cesarean and for the provider to explain why that is or is not a good idea. A part of that discussion will be how many children that you plan to have all together. Then together, they will come up with a plan for the delivery. 

Why Some Women Are Considering It

There are women who suffer from tocophobia, the fear of childbirth. While many women have a healthy respect for labor, and are concerned or worried about it, there are also women who have a deep seated fear.

There are also women who are making this as a choice of convenience. Or those who do not wish to give birth vaginally. While some may say emotional issues or trauma would count as elective, I would rather see those marked under medical necessity, because our mental and emotional health is important and does influence our physical health.

How often are people having elective c-sections?

According to the Listening to Mothers II Survey, very few mothers are actually initiating the discussion about elective cesarean section. Another study showed that 43% of doctors were unwilling to perform an elective cesarean. The surprising news was that doctors were more likely than the mothers to have that discussion.

If your practitioner agrees to perform an elective c-section, it should not be perform until you are past 39 weeks of pregnancy to reduce the risk of preterm delivery of your baby. It is also important to note that your insurance company may not cover elective c-section for no medical reason because of the added risks of complications to you, your baby and future pregnancies. Be sure to discuss this with your insurance provider.

Sources:

Campo-Engelstein L, Howland LE, Parker WM, Burcher P. Scheduling the Stork: Media Portrayals of Women's and Physicians' Reasons for Elective Cesarean Delivery. Birth. 2015 Jun;42(2):181-8. doi: 10.1111/birt.12161. Epub 2015 Apr 16.

Kalish RB, McCullough LB, Chervenak FA. Curr Opin Obstet Gynecol. 2008 Apr;20(2):116-9. doi: 10.1097/GCO.0b013e3282f55df7. Patient choice cesarean delivery: ethical issues.

Klein MC.Cesarean section on maternal request: a societal and professional failure and symptom of a much larger problem. Birth. 2012 Dec;39(4):305-10. doi: 10.1111/birt.12006. Epub 2012 Nov 5.

Timing of elective repeat cesarean delivery at term and neonatal outcomes. Tita AT, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, Moawad AH, Caritis SN, Meis PJ, Wapner RJ, Sorokin Y, Miodovnik M, Carpenter M, Peaceman AM, O'Sullivan MJ, Sibai BM, Langer O, Thorp JM, Ramin SM, Mercer BM; Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network. N Engl J Med. 2009 Jan 8;360(2):111-20.

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