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Mothers should be counseled that the most concerning risks related to maternal request cesarean delivery are neonatal respiratory morbidity and those that may affect the mother's future reproductive health, including life-threatening conditions, such as placenta accreta. The literature suggests that overall risks of maternal complications with cesarean delivery on maternal request are slightly lower than a trial of vaginal delivery and are primarily driven by the avoidance of unplanned or emergent cesarean deliveries and their associated increased rate of complications. When addressing risks and benefits with patients, there are three areas of importance. First, the risks for neonatal respiratory morbidity and abnormal placentation with future pregnancies should be emphasized. Secondly, there are many areas on which studies are lacking. Finally, numerous factors can alter the risks and benefits—such as culture, maternal obesity, and provider background—and should be acknowledged.
a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA
b Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032, USA
Corresponding author.
Mary E. D'Alton has worked as a consultant for Artemis Health, Inc., Menlo Park, California.
PII: S0095-5108(08)00050-X
doi:10.1016/j.clp.2008.07.006
© 2008 Elsevier Inc. All rights reserved.
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