Should women who elect to have caesarean sections pay for them?

doi:10.1136/bmj.318.7190.1070

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I Z MacKenzie, Reader in obstetrics and gynaecology

Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Headington, Oxford OX3 9DU

EDITOR—The issue of whether doctors should perform elective caesarean sections on request confronts obstetricians almost daily.1 Neither the original articles in the BMJ on elective caesarean section nor the correspondence that followed quantified the problem in the United Kingdom. 1 2

The table illustrates the primary indications for 978 caesarean sections performed before labour in 1976, 1986, and 1996 at the John Radcliffe Hospital in Oxford. The information …