Viewpoint: How physicians should handle patients' C-section requests

When expectant mothers request a Caesarean section without any medical or surgical reasons, physicians must walk a fine line of empowering women to advocate for health outcomes, while still following the ethical core of the Hippocratic oath — "doing no harm," Julia Kfouri, MD, assistant professor in the department of obstetrics and gynecology at the University of Toronto, wrote in an op-ed published by The Star.

Here are three things to know:

1. The term "Caesarean delivery on maternal request" applies to these planned C-sections that some mothers see as a more controlled way to give birth, according to Dr. Kfouri.

2. First time mothers requesting C-sections may not realize the complications associated with the procedure, said Dr. Kfouri. For example, scar tissue from the procedure can form around major abdominal organs, creating future potential for surgical risks. In rare cases, a woman's uterus can rupture during her next delivery if the organ did not heal properly from a previous C-section.

3. Due to the risks associated with CDMRs, maternity care teams are hesitant to grant this request, according to Dr. Kfouri.

"What we must do, however, is explore deeply and repeatedly the worries and experiences that have led a woman to request a CDMR in the first place," she wrote in the op-ed. "Some may fear pain and reviewing the spectrum of available pain management options in labor may alleviate these anxieties."

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