Caesarean delivery on maternal request: a personalised approach informed by principle-based ethics

Learning Points

  • Caesarean delivery on maternal request (CDMR) is a commonly encountered clinical scenario in Australia, accounting for 17% of all caesarean deliveries.
  • The approach to CDMR should include assessment of medical suitability as well as discussion of the factors motivating the patient’s preference to ensure caesarean delivery will be in the interests of the overall health and wellbeing of the mother and fetus. Gaining genuinely informed consent through detailed and objective communication of potential risks and benefits is also vital in respecting patient autonomy.
  • A woman’s preference for caesarean delivery is often the product of a complex interaction between personal, cultural, and environmental factors. Consideration of ethical principles such as autonomy, beneficence, non-maleficence, and justice provides a suitable framework by which the clinician may evaluate the ethics of performing a caesarean delivery. However, it does not generate an ethical obligation to do so.

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