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Should women be able to request a caesarean section? No

BMJ 2011; 343 doi: (Published 23 November 2011) Cite this as: BMJ 2011;343:d7565
  1. Hanna Rouhe, senior resident
  1. 1Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
  1. hanna.rouhe{at}

Michael Turner (doi:10.1136/bmj.d7570) argues that a fully informed decision to choose a caesarean section should be accepted, but Hanna Rouhe believes surgery should be restricted to women with clinical need

Although every childbirth carries a risk for both mother and child, these risks are very small in Western countries.1 Yet obstetricians around the world have started to think that the “requested” caesarean section is an acceptable prophylactic response to the uncertainty of vaginal delivery. Effects of this changed practice can be seen in caesarean section rates around the world, which have risen above the optimal amount—for example, 33% in Italy or over 50% in Brazil. Have we forgotten, or do we simply neglect, the much higher risks of complications for caesarean sections?2 I hope that doctors do not agree to women’s requests for a caesarean simply for the transient convenience. There is no evidence that an elective caesarean section is safer than …

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