The Official Word...

Here's what professional organizations have to say about elective  C-sections

Compiled by Suzanne Taylor

Spring 2007

Society of Obstetricians and Gynaecologists of Canada (SOGC) media release   "The Society of Obstetricians and Gynaecologists of Canada does not promote Caesarean sections on demand. The Society has always promoted natural childbirth and believes that the decision to perform a Caesarean section during labour and delivery should be based on medical indications."   read the full media release back to top

International Federation of Gynecology and Obstetrics (FIGO)   "Physicians have a professional duty to do nothing that may harm their patients. They also have an ethical duty to society to allocate health care resources wisely to procedures and treatments for which there is clear evidence of a net benefit to health. Physicians are not obligated to perform an intervention for which there is no medical advantage."     "At present, because hard evidence of net benefit does not exist, performing Caesarean section for non-medical reasons is ethically not justified."   read the full statement in pdf back to top

American College of Obstetrics and Gynecologists (ACOG) committee opinion   "If the physician believes that cesarean delivery promotes the overall health and welfare of the woman and her fetus more than vaginal birth, he or she is ethically justified in performing a cesarean delivery."   "If taken in a vacuum, the principle of patient autonomy would lend support to the permissibility of elective cesarean delivery in a normal pregnancy, after adequate informed consent. To ensure that the patient’s consent is, in fact, informed, the physician should explore the patient’s concerns. For example, a patient may request elective cesarean delivery because she is afraid of discomfort during labor. In this case, providing her with information about procedures available for effective pain relief during labor may result in an agreement to proceed without surgrey."   "Finally, given the lack of data, it is not ethically necessary to initiate discussion regarding the relative risks and benefits of elective cesarean birth versus vaginal delivery with every pregnant patient. There is no obligation to initiate discussion about procedures that the physician does not consider medically acceptable or are unproved."   read the full committee opinion in pdf back to top

Canadian Association of Midwives   "Vaginal birth is clearly the safest birth for most women and babies, and . . . caesarean surgery on demand will have disastrous social and financial consequences for health internationally."   "The benefits of caesarean section and certain obstetrical interventions for specific problem situations are irrefutable. However, widespread use of intervention and technology creates fear and doubt about the adequacy of the female body, and reinforces distrust about the reproductive powers of women."   "Presenting interventions such as c-section as "options" puts maternity care providers and women in a consumerist relationship, and treats childbirth as a problem to be solved rather than a process to be respected."   "Embedded in a historical and socio-cultural context, childbirth is far more than a medical event."   read the full statement back to top

International Cesearean Awareness Network   "ICAN's mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC)."   "Research published just in the last year has highlighted the short-term and long-term risks of undergoing a cesarean, for both mother and baby. Other research has called into question the assumed safety advantage of cesarean section over vaginal birth in various situations including vaginal birth after multiple cesareans and breech deliveries."     read the full position statement back to top

Doulas of North America   "DONA believes the opinion of the American College of Obstetricians and Gynecologists that deems physicians ethically justified to perform elective cesareans without a medical reason has caused alarm for major women's health organizations. DONA believes this opinion downplays the risks to mother and baby when non-medically necessary cesareans are preformed."   read the full press release back to top

Lamaze International   "Elective or “maternal request” cesarean surgeries pose serious and life-threatening complications for mothers and babies. Despite the risk, the popularity of elective cesarean surgery continues to rise."   "An elective cesarean is defined as a pre-planned cesarean surgery for which there is no medical necessity. The primary reasons attributed to elective cesarean surgery include scheduling conveniences, avoiding the pain of labor and preventing future pelvic floor disorders, such as incontinence and pelvic organ prolapse. The critical review of research, however, indicates that women who undergo elective cesarean surgery increase the risk of infection, future reproductive problems, uterine rupture, preterm birth, low birth weight, respiratory problems and death for themselves and their babies. Furthermore, new research indicates little, if any, benefit to the pelvic muscles in the long-term with cesarean surgery vs. planned vaginal birth."   read full statement back to top