Elective C-sections- moms idea or the providers?


  • Specializes in maternal-child, float. Has 11 years experience.

Hi all, I am an RN who is getting her PhD, why I am still not sure most days, but as my background is all maternal-child I was looking into the idea of maternal request c-sections, the "too posh to push" theory, and was wondering if you all had any opinions on this. (Usually you can count on nurses for their opinions!) In my experience it often seemed like the elective sections frequently thought it was the docs idea, (baby too big, etc), while the docs are calling that patient choice, which I guess it is, but as a nurse and therefore a patient advocate it concerns me that many patients seem to think the section was the only choice. I am not disagreeing that some patients are requesting c-sections, just wondering if the numbers are as high as the media seems to make it and if we are really educating them well enough on the topic. Any thoughts? Thanks for any and all input!

nyteshade, BSN

555 Posts

Specializes in Legal, Ortho, Rehab. Has 20 years experience.

Funny you bring that up...I haven't had any babies yet, but most of my co-workers have had their first baby within the last 3 years. They all mentioned that the doc suggested c-section R/T pelvic inlet not allowing a NSVD. Hmmm I do suspect the insurance companies may really be behind it all...


1 Article; 187 Posts

I was overdue with my son, and the OB doc estimated him to be a big (10lb+) baby. He kept hinting around that I would need a C-section. At my insistence at 1 week overdue I was induced, uncomplicated vaginal delivery of a 8lb11oz boy. However, I have to tell you, I thought for sure I was going to end up having a section, and I would imagine had I asked for it I wouldn't have had to insist as hard as I did for the induction.

LibraSunCNM, MSN

1,632 Posts

Specializes in OB. Has 10 years experience.

As a future midwife, I'm interested by this question as well. It seems like "maternal request" is a common reason OBs cite for high C-section rates, and yet I've heard anecdotally that the number of women requesting sections for absolutely no medical reason is really only around 1%. However, I'm not sure where that data came from and would be interested to find out more.


27 Posts

I hope my response does not offend anyone, and this opinion is specifically for elective C-sections- they should be outlawed. Doctors who push them for easy scheduling or insurance/ money purposes should have their licenses taken away, and women who do not want to give birth to a baby should not have a baby. It is in my opinion that our bodies were made to have children, and unless there is a medical emergency there is no reason to interfere. My mother's first child was a breech vaginal birth, and my stepsister delivered a 12 pound baby vaginally- these days a doctor would have pushed a C-section on both of them. Somehow they were just fine.


862 Posts

In my experience the patients who "request" them were more accurately talked into requesting them by their OB. Such as "Did you want to schedule a c-section? That might be good for X,Y,Z. It's up to you of course. I mean, I am not sure your pelvis is large enough anyway" etc, etc. It's my opinion that every woman has the right to the delivery method of her choice- homebirth, unassisted birth, hospital birth, epidural, no epidural, scheduled c-section, you name it. I also believe as health care providers we have a responsibility to our patients to educate them about the risks and benefits of their choices. I truly believe that no woman when properly educated about elective cesarean would take that choice. In my opinion the choice of an elective section without medical indication is far more irresponsible than those who choose to birth unassisted. Providers who encourage them are working on a questionable moral foundation and certainly do not have their patients' best interest in mind.


520 Posts

Specializes in LTC.

Well, my now nearly 3 yr old was unfortunately a c section. On Jan 20 2007 I went to my baby shower in alot of pain....just dealt with it...til about 11 or 12 that night...had my buddy take me to the ER where they gave me stadol and phenergen IM....which btw...did NOTHING. They sent me home and told me to walk etc etc...that my labor was starting and I was completely thinned out and 2 cm dilated...ok....next night the 22nd..I went back to the ER w/ same thing.....but worse...and they told me I was "under 4 out the door"...gave me a freakin darvocet and sent me home to wait on my next appt which was the 24th.....I noticed my sons HR was over 200....which led me to think the cord was wrapped...they told me "nah.....hes just too active"....ok...so the 24th comes and the doc checks me....got that "look" and sent me to ultrasound....and guess what.....he was breech.....so the next am I was at the hospital waiting on a c section. I thought that would be the death of me. I thought I was having a heart attack right there on the OR table. I truly feel like if a doc had come up to the hospital to check me out those 2 nights instead of giving med orders to the nurses...my son would not have been breech and c section wouldnt have happened....and I was right....his cord was wrapped 1 x around his neck...I had tried to tell them that....but no one listened to me. My section was unavoidable to an extent....I thought it was downright cruel to let someone labor....even a lil bit for that long and do nothing about it. I was begging to be induced....that was a no go too.


411 Posts

It seems like every other woman I meet had an "emergency C section". After gently probing, you most often find out it was failure to progress (was the baby in any danger?), overdue (or simply just term...get that baby out), and as mentioned above "well, I labored for 8 hours with no progress, and thank goodness the Dr. was there to do that C section becaus eif not...XYZ might have happened" Typically, they labored for 8 hours, after being induced, supine, with an epidural before 4-5cm dilation. No progress? go figure.

Any time anyone asks me how to get a natural birth, I tell them you investigate out of hospital birth. I sincerely cannot imagine what it must take to pull off a natural labor and delivery in most L&D units today. Short of showing up crowning....which one friend did, thought not intentionally...where can a woman give birth without being being pressured into Pit and an Epi?

As for the original question, I do believe some women simply prefer or think it's cool to request a csection. It's typically not very well thought out, maybe they want to avoid pain (fair enough), maybe they want convenience, maybe their partner is convinced it will prevent their vagina from becoming loose (yup, heard that in clinical once). We don't value the work of labor, the transformational power of birthing.

I intend to begin in my circle. Speaking a positive message of birth, to my friends, clients, and children. It is hard work, it hurts, and it can be done.


862 Posts

We don't value the work of labor, the transformational power of birthing.


I totally agree with this. There is absolutely no value placed on the process of giving birth or the transformation to motherhood.

Specializes in NICU.

oooh I could write pages and pages about this, in fact I have written MANY pages for a school paper. This whole baby-on-demand thing, too posh to push, "failure to progress"...it all angers me to no end.:angryfire

I was born 28yrs ago NSVD, no epidural big butt first!!!

My sister was born 32yrs ago, NSVD, no epidural, big butt first!!!

My little sister was born 23yrs ago, NSVD head first no epidural!!!

My oldest sister, 33yrs old was induced at 35wks due to maternal fever and UTI. She ended up in NICU for a couple of days under phototherapy but that was all (lucky). That was my mom's only epidural and the only time she had Pit!

so WHAT happened???

Now, as a NICU nurse I attend SO many c-sections. Hardly ever do we see vaginal deliveries.

I would NEVER deliver at the hospital where I work and that is bc the docs there have no patience. 8-10hrs of labor and all of a sudden it's failure to progress. One little descel and BAM, to the OR it is!

Angers me so much that my thoughts get mixed in my head and I can't even express how angry I am about all these elective c-sections by doctors and mom's demand!


476 Posts

Specializes in NICU.

I am a firm believer that women should be presented with facts and allowed to make decisions (without prodding from their health care provider) about their childbirth choices. I gave birth at a huge hospital in a very 'crunchy' college town. No one there flinches at hypno birthing, if it gives you any idea of the approach to birthing that they take. I completely planned to have a natural childbirth, controlling my pain with non-pharm methods. Didn't happen. The concept that because I didn't have a vaginal birth, I missed out on the 'transformation of motherhood' is ridiculous. Along with that, I HATE having to defend the birth of my daughter to complete strangers who make the assumption that she was a c-section because of failure to progress. It happens really, really often that I have to explain that she was 11 days overdue, recurrent late decels were detected once I got to triage, no interventions could correct them, her heart rate wasn't recovering and by the time she was born (an hour after I reached triage) her heart rate was below 70. She spent a week in the NICU because of tachypnea and an infection caused by my chorioamnionitis (which no one had any idea I had until the c/s). I walked into triage dilated to a 2, and went straight to the OR (well....after the half an hour it took to get an IV into my dehydrated veins). But instead everyone immediately jumps down my throat and assumes I just didn't feel like laboring anymore. All of this makes me wonder why we as women (because it does seem to be majority women that feel so strongly about this) are SO passionate about how other women give birth, to the point that we are willing to make eachother feel like horrible people if we didn't chose the 'correct' method (or if nature deemed otherwise).

HeartsOpenWide, RN

2 Articles; 2,889 Posts

Specializes in Ante-Intra-Postpartum, Post Gyne.

I blame media. C/S became a status symbol in the 50's when Hollywood starts asked to have c/s to save themselves the strain of laboring and in some instances to schedule birth conveniently between movie contracts. The average woman came to think of C/S not as a surgical procedure but as a easy method of painless childbirth. Elective C/S not a new thing.

1) how many NATURAL births do you see on Discovery Health/TLC? Most are high risk, show mom in a lot of pain (often do to the interventions of hospital birth) not often do you see a home birth, childbirth center birth, or hospital birth with nothing more than an I.V. lock...at least not in near proportion to the action packed high risk deliveries

2) De-sensitization, the more women have C/S that are not for REAL reasons (crashing baby, placental abruption, placenta previa, true CPD-which generally is an over used term for "impatient doctor"-true CPD is in poor malnourished women; as in rickets...many women have been DX with CPD to only have a baby with an even bigger head their second time aroud; uterine rupture; and some cases of twins) the more "normal" it seems, people seem to even forget is SURGERY

3) we live in a microwave/drive thru society and we want to know when our food will be ready, even are babies

4) not all area allow a VBAC

5) What happens at 99% of baby showers? "It was so embarrassing, I pooped all over the doctor!...Oh my Gosh make sure you get an epidural, those contractions make menstrual cramps feel like an orgasm... I just about died from the pain!...I thought I was going to be ripped in two!!...I nearly did rip in two, vagina to anus!!" enough to scare the crap out of a woman; one horror story after every present...