Intended for healthcare professionals

Rapid response to:

Letters

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

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7190.1070 (Published 17 April 1999) Cite this as: BMJ 1999;318:1070

Rapid Response:

The issue of elective Caesarean sections

Mr MacKenzie raises the financial implications inherent in Caesarean
section following maternal request and like many others warns that we must
inform women of the dangers of elective Caesarean section compared to
vaginal delivery. Unfortunately, this argument is becoming increasingly
difficult to justify. The data on the increased postoperative
complication rate which all obstetricians quote are historical and based
upon all Caesarean sections, both elective and emergency. The latest
report on the Confidential Enquiry into Maternal Death(1) reported no
deaths from elective Caesarean section.
Until we have up to date data on the incidence of haemorrhage, DVT and
infection from elective and emergency Caesarean section reported
separately we will not be sure of the position but it is becoming
increasingly obvious that elective Caesarean section if probably much
safer than was previously thought. If so, then our much loved arguments
in favour of vaginal delivery become difficult to defend.

1 Why mothers die. Report on the Confidential Enquiry into Maternal
Death. HMSO 1998

Competing interests: No competing interests

16 April 1999
Douglas Tincello
Lecturer in Obstetrics & Gynaecology
Department of Obstetrics & Gynaecology, Liverpool Women's Hospital