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Rapid response to:


Time of birth and risk of neonatal death at term: retrospective cohort study

BMJ 2010; 341 doi: (Published 15 July 2010) Cite this as: BMJ 2010;341:c3498

Rapid Response:

Planned cesarean delivery benefit

The unpredictability of planned vaginal delivery or a trial of labor
(i.e. the possibility of assisted delivery and/or emergency surgery) is
one of the reasons often cited by women who decide to deliver their babies
by planned cesarean.

This study illustrates that the unpredictable nature of the delivery
outcome itself (and any associated morbidity or mortality) is not the only
risk these women seek to avoid. The unpredictability of the quality of
care available at different hours of the day and night when women arrive
at hospital in labor is another risk they do not wish to take, especially
when this might impede the safe and healthy arrival of their baby.

The 'convenience' of scheduling a time and date for maternal request
cesarean delivery is sometimes criticized as an irresponsible benefit of
surgery, but when looked at from the perspective of this study (and others
like it), there is clearly a legitimate benefit involved in knowing
exactly who will deliver your baby and when, and it has nothing whatsoever
to do with convenience.

Competing interests:
Editor of

Competing interests: No competing interests

22 July 2010
Pauline M Hull