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CPG Infobase: Clinical Practice Guidelines

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Record Id:
19146
Title:
Caesarean delivery on maternal request
Fulltext:
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Author
Alsayegh E, Bos H, Campbell K, Barrett J
Publication/Review date:
2018-July 
Producers:
Society of Obstetricians and Gynaecologists of Canada

Bibliographic Source

Journal Citation:
J Obstet Gynaecol Can 2018;40(7):967-72.
Pages/Size:
5  Page(s)
References:
34
Notes:
SOGC clinical practice guidelines No. 361

Subject Information

Specialties:
Obstetrics and gynecology,
Conditions:
Obstetric Delivery ;
Domains:
Treatment
Target Populations:
Pregnant or Nursing Mother
Target Gender:
Female
MeSH:
Elective Surgical Procedures; Counseling; Pregnancy; Labor, Obstetric; Cesarean Section;

Structured Abstract:

Recommendations:
1. A maternal request for an elective caesarean section in the absence of a maternal or fetal indication may raise risk-benefit considerations and ethical concerns for a health care provider

2. Appropriate counselling of the patient on the risks and benefits in proceeding with a Caesarean delivery on maternal request (CDMR) without medical indication is essential. Providers should have a clear knowledge of the risks and benefits of providing an elective Caesarean section without medical indications compared to the risks and benefits of supporting an attempt at vaginal delivery, so that the patient may reach an informed decision. The principle of patient autonomy should be respected but other ethical principles (beneficence, non-malificence and justice) need to be taken into consideration during the counselling process.

3. There are no studies to estimate maternal and neonatal risks in CDMR. Often studies on Caesarean section before the onset of labour are used as surrogates to determine risks and benefits.

4. After exploring the reasons behind the patient's request, and discussing the risks and benefits, if a patient insists on her choice a physician may pursue one of the following two options:

a. Agree to perform the Caesarean section after 39+0 weeks gestation
b. Disagree and refer the patient for a second opinion

Copyright:

The copyright of this guideline and its companion documents belongs to: Society of Obstetricians and Gynaecologists of Canada

Disclaimer:
All content is provided for information and education and not as a substitute for the advice of a physician. Joule assumes no responsibility or liability arising from any error or omission or from the use of any information contained herein.

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