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More Women Want Cesarean Sections

Report Shows Complication Rate No Higher Than With Vaginal Delivery

Evidence 'Incomplete'

Last October, the nation's largest group of ob-gyns weighed in on the issue of elective C-section -- albeit tentatively. An American College of Obstetrics and Gynecology ethics committee declined to endorse or condemn the controversial practice, leaving the decision to individual physicians and patients.

The report noted that an increasing number of women are requesting elective cesareans in the belief that the surgery will lower their risk for delivery-related incontinence or sexual problems, while many physicians were still unwilling to consider the practice.

"ACOG cautions that both sides of this debate must recognize that evidence to support the benefit of elective cesarean is still incomplete and that there are not yet extensive morbidity and mortality data to compare elective cesarean delivery with vaginal birth in healthy women," the report states. "With better data, there may be a shift in clinical practice."

Robert Lorenz, MD, who helped write the report, says it also included language stating that in the face of inadequate information, the "burden of proof" should lie with those who want to replace the natural process of vaginal childbirth with major surgery.

"A woman considering an elective C-section should consider her doctor a resource to help explore her feelings," he says. "If she is worried about the pain of labor, we can address that. If she is worried about her baby's welfare, we can address that to, and she may decide that she doesn't really want surgery."

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