Let science and ethics guide primary elective c-section decisions.(The Master Class)

A healthy 21-year-old woman (gravida 1 para 0) presents to your office for prenatal care. She calmly explains during her first visit that she would like to have an elective cesarean delivery.

Twenty years ago, the consensus was that no obstetrician should perform a primary elective cesarean in the absence of any indication for the procedure beyond patient preference. Today, although the American College of Obstetricians and Gynecologists has taken the position that, on balance, a vaginal delivery remains a safer option, the decision is not such an easy one. Indeed, many obstetricians are uncertain just how to respond to such patient requests.

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