Do Women Really Want On-Demand C-Sections?

January 23, 2008

The question of whether maternal requests for c-sections could be contributing to rising rates of the procedure is a hot topic – the National Institutes of Health held a conference on the issue, ACOG has issued statements guiding its member OB/GYNs, and there has been no shortage of media coverage. In general, there does not appear to be any consensus that there is significant demand from women for c-sections that are not medically indicated, with the NIH calling requests “difficult to quantify.”

Previous results from the Listening to Mothers II national survey of childbearing women found that “Of the 1573 women surveyed, just one mother said that she had had a planned initial cesarean by her own choice with the understanding that there was no medical reason,” and suggested that the NIH panel’s estimate of maternal demand for c-sections may not be accurate:

“…working with a leading polling firm to ask mothers themselves results in an estimate of just 0.2% of all cesareans (1/480) by maternal request in 2005, and suggests that the panel’s reported estimate of 4 to 18% of all cesareans grossly overestimates this phenomenon.”

A small study in the new issue of the American Journal of Obstetrics and Gynecology also attempts to address the question of whether women are truly clamoring for c-sections. Researchers surveyed 314 pregnant women in the Bronx, and 95% of women responded that they did not believe cesarean delivery on maternal request was “a good idea,” and 93% said they preferred to deliver vaginally. Although the authors note that their sample is small and may not be representative of all American women, it’s an interesting start in trying to quantify this supposed trend.

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