Elective caesarean delivery - the right choice for whom?

Caesarean delivery on maternal request is a subject of heated debate. Concerns about incontinence and prolapse in later life, and regarding vaginal trauma at birth are common reasons for patient choice caesarean delivery. Available evidence comparing planned vaginal delivery and planned caesarean delivery is scarce and not robust enough to evaluate fully the benefits and risks of these delivery modes. Clinicians should keep an open mind in relation to patient requests. It is mandatory that full, honest and unbiased information should be given based on the available information, though limited, and that women should participate fully in the decision making process. Consideration should be given to individual characteristics and conditions. The decision to perform caesarean delivery on maternal request should be individualized and consistent with the ethical principles of beneficience, justice and autonomy.