[Elective caesarean section].

Abstract

As a part of the ongoing debate surrounding the steady increase in the rate of caesarean sections in general, the issue of elective caesarean section - following a complication-free pregnancy and in the absence of clear medical evidence actively suggesting a caesarean section - has likewise been addressed in greater depth. The progressive decline in mortality attending a well-planned caesarean section along with the reduction in morbidity brought about by improvements in caesarean section techniques have served to direct the attention towards the less apparent maternal and fetal risks of vaginal delivery. At the same time, the growing importance attached to the patient's input has made a clear definition of the concept of 'indication' more difficult. However, the distinction between medical indications and the freedom of choice of the patient is, in the predominant number of cases, an artificial one - in the ideal scenario, obstetrician and patient arrive at a joint decision after carefully considering the advantages and disadvantages of all relevant alternatives. Hence the term 'caesarean section on demand' needs to be recognized as prejudicial and needs to be replaced with the more accurate 'elective caesarean section'. Not only is ethical dilemma avoided in the process, but medical insurance agencies are left with no reasonable grounds to refuse support to such a procedure.