What Does Research Tell Us About Planned Vaginal Delivery Versus Cesarean Delivery on Maternal Request Outcomes?
This significantly limits the reliability of judgments regarding whether an outcome measure favors either cesarean delivery on maternal request or planned vaginal delivery."
Though the statement does provide some explanation for each of the outcome variables, the majority of the information is presented with an evident bias toward validating cesarean delivery on maternal request. For example, maternal hemorrhage, which is one of the moderate quality evidence variables, is noted to be more frequent with a combination of planned vaginal delivery and unplanned cesarean delivery than with planned cesarean delivery.
Throughout this section of the state-of-the-science statement, the panel opts to support cesarean delivery on maternal request rather than promoting practices that support normal birth.
In making a decision as to whether or not a cesarean delivery on maternal request is an appropriate choice for a woman, the panel indicates that the cultural and personal importance of labor and birth for a woman should be evaluated.
A brief mention of the impact of media coverage highlights the fact that the public may become more interested in cesarean delivery on maternal request as the media focuses even more on the concerns of risk and potential maternal and/or fetal morbidity linked with planned vaginal delivery: "Such a shift in acceptance by patients and providers may lead to an increase in cesarean delivery on maternal request."
A cursory internet search for information related to elective cesarean and cesarean delivery on maternal request produced numerous articles and press releases resulting from the release of the NIH state-of-the-science statement itself.
The only true national data on cesarean delivery on maternal request stems from the second Listening to Mothers survey.
* Will the media attention to cesarean delivery on maternal request create a self-fulfilling prophecy?
Sorely needed is a comprehensive, nationwide research effort to more precisely understand the risks and benefits--for both mother and child--of cesarean delivery on maternal request as compared with both planned vaginal delivery and medically advised cesarean section.
(2.) National Institutes of Health State-of-the-Science Conference statement: cesarean delivery on maternal request, March 27-29, 2006.