Caesarean delivery on maternal request

Cesarean delivery on maternal request (CDMR) is a caesarean section birth requested by the pregnant woman without a medical reason.

The concept of "caesarean delivery on maternal request" is not well-recognized in health care, and consequently, when it occurs there are not mechanisms in place for reporting it for research or distinguishing it in medical billing.

Over the last century, delivery by CS has become increasingly safer. The medical reasons for selecting CS instead of a vaginal birth therefore could become "softer", and the move to perform CS on request can be viewed as an extension of this development. Until recently an elective caesarean section was done on the basis of some medical grounds; the CDMR situation, however, makes the mother's preference the determining factor for the delivery mode.

An elective caesarean will be agreed in advance. An elective caesarean can be suggested by either the mother or her obstetrician, often as a result of a change in the medical status of the mother or baby. The term is used by the press and on the web in a number of different ways, but any caesarean section which is not an emergency is classified as elective. The mother in essence has agreed to it but may not have chosen it.

The popular media suggest that many women are opting for caesareans in the belief that it is a practical solution. The ethical view that a woman has the right to make decisions regarding her body has empowered women to make a choice regarding the method of her childbirth. Furthermore, with women living longer, concern about damage to the pelvic floor organs by vaginal delivery adds an additional dimension to the issue. Such damage could lead to a relaxation in the ligaments that hold the pelvic organs in place; urinary incontinence can become a consequence.

The movement for CDMR may have started in Brazil. It has been estimated that possibly 4-18% of all CSs are done on maternal request; however, estimates are difficult to come by. The global nature of the CDMR phenomenon was underlined by a study that showed that in southeast China about 20% of women chose this mode of delivery.

Increasingly, caesarean sections are performed in the absence of obstetrical or medical necessity at the patient's request, and the term Caesarean delivery on maternal request has been used. Another term that has been used is "planned elective cesarean section". As of 2006, there is no ICD code, thus the extent of the use of this indication is difficult to determine. The mother is the only party who may request such an intervention without indication.

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Wikipedia