Cesarean Section on Demand

The clinical field has acknowledged the possibility of patients to be actively engaged in making decisions that affect their care. They can make critical decisions regarding their treatment, including the delivery procedure. From the same perspective, mothers can select the type of birth they prefer. A cesarean section on demand is a personal decision of a mother to deliver through a cesarean section instead of vaginal birth (Intraprasert & Suthutvoravut, 2017). Mothers can make the decision based on various reasons, including fear of delivery and pain, past experience, better care during childbirth, and the need to maintain the pelvic floor’s integrity. Although elective cesarean delivery is a controversial issue, just like people have accepted plastic surgery as long as the patient gives consent, the same should apply to cesarean section on demand. Thus, mothers should have the freedom to make an informed decision regarding birth, including a cesarean section on demand.

Support for Thesis

Cesarean section delivery should be allowed from an ethical perspective. Various ethical principles apply to the decision to allow mothers to choose an elective cesarean section as opposed to vaginal birth or the possibility of an emergency cesarean section. Medical experts should allow patients to have the right to their medical process, including the decision to have a cesarean section on demand.

Autonomy

Autonomy is one of the ethical principles that apply to the situation (Gallin & Ognibene, 2012). Patients should be given the right to make their informed decisions regarding the nature of the desired treatment option. Medical practitioners should only provide their patients with adequate information to make their independent medical decision. The doctor should explain to the mother the pros and cons of the surgery and allow her to decide (Ralston & Farrell, 2015). If the mother chooses to have an elective cesarean section, the physician-patient rapport will increase the chances of safe pregnancy, delivery, and post-delivery care. The medical team should support the patient during the treatment and not decide on her behalf. Generally, the mother should have the opportunity to make the final decision regarding their delivery procedure.

Beneficence and Nonmaleficence

The principles of beneficence and nonmaleficence are useful in deciding to have a cesarean section on demand. Health care providers have the duty to bring about good. They should take steps to prevent harm to their patients (Gallin & Ognibene, 2012). Women should have the right to select a cesarean section on demand because the process is safe. The mode of delivery might even be more reliable compared to vaginal delivery. The danger of maternal hemorrhage is common during vaginal delivery due to uterine atony. Hence, mothers can prevent the condition if they delivery early without experiencing labor and going through vaginal birth. The risk is high if labor is induced or not. The same risk occurs during an emergency cesarean section but can be avoided with an elective cesarean section. Besides avoiding the risk, women can overcome the fear of pain when making the decision to have a planned cesarean section (Preetkamal & Nagpal, 2017). The mother might be afraid of the process and the failure to receive pain medications. She could also want to have the elective cesarean section to prevent the possibility of an emergency operation.

Mothers prefer cesarean section on demand because of their safety and those of their babies. Through the mode of delivery, the woman can protect the baby and prevent transmission of perinatal infections, such as human papillomavirus, hepatitis, herpes, HIV, or group B streptococcus. The protection is possible because the cesarean section is conducted before the rupture of membranes. A planned cesarean section at the 39^th and the 40^th weeks can lower the danger of in utero death considerably (Harper, Goetzinger, Biggio, & Macones, 2015). In natural delivery, the risk of death of the fetus increases over the pregnancy term. Therefore, a cesarean section on demand reduces the risk of death. The degree of meconium aspiration would reduce because 23 percent of pregnancies affected by meconium fluid transpire after the 41^st week (Harper, Goetzinger, Biggio, & Macones, 2015). If women fail to labor, the process can reduce complications related to vaginal delivery, including the danger of intracerebral hemorrhage, the arm or clavicle fracture, brachial plexus injury, shoulder dystocia, and asphyxia (Harper, Goetzinger, Biggio, & Macones, 2015). Therefore, women should have the right to make such a life-saving decision.

Justice

The principle of justice also applies to the cesarean section topic. Medical professionals should treat their patients fairly (Gallin & Ognibene, 2012). Women have the right to choose how to treat their bodies and sexuality. Active women have serious concerns about the integrity of their pelvic floor; hence, they desire to remain active in exercise without any limitations. They are concerned about their sexual function to maintain their intimate relationships. They prefer cesarean section on demand to have the necessary assurance that they will preserve their body and sexual functions. Besides, women and the doctor can control the environment in which the delivery is conducted. The cesarean section ensures that they have adequately planned for the delivery. It also means that the team of experts, the physician, and anesthesiologist are available to support the mother during the scheduled cesarean section (Riley, 2014). Furthermore, the emergency cesarean section can be traumatizing for the mother and the baby. It can easily cause postpartum depression and posttraumatic stress disorder. Planning the delivery and having control over the processes reduces the danger of these conditions.

Women prefer to see and even hold their babies once they are born. It is what they consider fair and just in their treatment process. With a planned cesarean section, mothers have the opportunity to hold their babies and experience the first moments of the child’s life through the skin-to-skin contact. The scheduled operation differs from an emergency one because the mother can have the baby in a more relaxed environment. The treatment team is attentive to the needs of the mother and child. She can work with her care provider to have a smooth delivery and hold the baby immediately after birth (Romanis, 2019). Besides, mothers have adequate time to prepare for the delivery because they do not have to wait for labor. As a result, they have enough time to prepare how to react upon the delivery of the baby.

Antithesis

Research has not provided adequate support for the safety and benefits of a caesarian section on demand. Although it is possible for the mother to decide about an elective cesarean section due to fear and uncertainty that surrounds vaginal birth, they disregard significant risks that can occur in the process. Women should not take cesarean section lightly because it is a major surgery that is accompanied by various risks, such as bleeding, bladder and bowel injury, infections, adverse reactions to medicines, blood clots, possible injury to the baby, and even the death of the mother or baby or both (Câmara et al., 2016). Another potential risk of the decision is the possibility of delivering a pre-term baby (between the 34^th and 36^th week). It is possible to have a wrong due date and schedule the cesarean early by failing to wait for the natural labor. The importance of having a smooth operation might not be worth the risk.

The cesarean section on demand can be costly for the patient and the hospital. Typically, the procedure is complicated and normally costs higher than vaginal birth. Besides, following the delivery, the mother and baby remain in the hospital longer than those who give birth naturally. On average, they remain admitted and receiving care two to four days longer compared to mothers who give birth vaginally. The danger to the health of the mother, such as physical complaints after delivery, can increase the length of stay in the hospital (Harper, Goetzinger, Biggio, & Macones, 2015). The recovery period for the women is also long because of pain and soreness associated with the procedure. She might experience abdominal discomfort and pain in the nerves surrounding the scar. It takes weeks and even months to heal from the surgery. Therefore, besides the cost of the treatment, the mother suffers the cost of postpartum treatment. The hospital also experiences a high cost of operation and management.

Refutation

A caesarian section on demand is as safe as any other mode of delivery. Studies have not revealed any change in mortality rates following the decision to perform an elective cesarean section. In fact, medical advances have led to safer deliveries through the elective cesarean section. Medical strategies, such as prophylactic heparin therapy, prophylactic antibiotic therapy, and the sequential utilization of support hose have improved the safety of cesarean section considerably (Intraprasert & Suthutvoravut, 2017). The maternal morbidity with cesarean section on-demand is similar to vaginal delivery. Therefore, the elective cesarean section does not increase the risk of mortality during delivery. Besides, with proper support and care, the safety of the baby and the mother is guaranteed regardless of the danger of pre-term delivery.

Some women are concerned about the cost of a cesarean section on demand. However, the cost of supported vaginal delivery with oxytocin is as high as an elective cesarean section. Besides, the benefits of the cesarean section on demand might outweigh the high cost of using the mode of delivery. In addition, the mode of delivery is beneficial to the hospital. In the long term, the drawback of treatment and negative outcomes of vaginal delivery and emergency cesarean section might be worse than the cost of the cesarean section. Some of the possible negative results that might require long term treatment are the reconstruction of the perineum and vagina, prolapse, and incontinence (Harper, Goetzinger, Biggio, & Macones, 2015). Therefore, it might be less costly to conduct the surgery than undergo the cost of post-vaginal delivery.

A cesarean section on demand are beneficial for the hospital and the operating staff. The process makes it possible for the hospital to improve the management of operating staff and time. It prevents challenges that are accompanied by emergency cesarean section. The delivery mode decreases the rate of emergency cesarean sections, which cause a reduction in the danger of accidents and adverse incidents that might cost the hospital a high cost to remedy (Harper, Goetzinger, Biggio, & Macones, 2015). The process reduces the cost of treating mothers with medical conditions that result from risky pregnancies and births. It also reduces the cost of taking care of babies with sequelae associated with childbirth and the cost of legal actions against the hospital. Therefore, in the long run, the cesarean section on demand reduces the cost that might result from risks associated with other methods of delivery. The presented facts indicate the potential benefits of elective cesarean section as opposed to vaginal birth or emergency cesarean section.

Conclusion

The decision by mothers to have a cesarean section on demand has become common in the modern medical arena. Besides, medical technology has improved the way the procedure is conducted, reducing the prevalence of maternal death during and after the cesarean section. However, the practice remains controversial, with some people opposing it for potential risk and cost, while others suggest the need to allow the mother to decide concerning childbirth. Regardless of the debate, an elective cesarean section should be allowed and supported as opposed to vaginal birth as long as it is upon the mother’s decision. The mother should be allowed the right to exercise the freedom to make an informed decision. Besides, the choice can be necessitated by concerns about the safety of the mother and baby. Medical grounds do not exist to deny the mother the right to decide about the way she wants to deliver her baby.