Caesarean section rates are progressively rising in many parts of the world. The
extent to which women´s request for caesarean section for non-medical reasons
has contributed to these rates, and why women make such requests, are contentious
issues.
Key messages
􀃎 There are no randomised controlled trials of planned caesarean section versus
planned vaginal birth for non-medical reasons at term, which makes the
comparability of the effects on perinatal and maternal morbidity and
mortality, and maternal psychological morbidity, for these two different ways
of giving birth challenging.
􀃎 The possibility of performing a randomised controlled trial of planned
caesarean section for non-medical reasons versus planned vaginal birth is
debatable, raising not only methodological questions but also moral and
ethics concerns of undertaking a trial where women randomised to the
intervention arm would receive surgery in the absence of a medical
indication.
􀃎 A systematic review of observational studies and a synthesis of qualitative
data to better assess the short- and long-term outcomes of planned caesarean
section compared with planned vaginal birth would be necessary.