title: Obstetric "conveniences": elective induction of labor, cesarean birth on demand, and other potentially unnecessary interventions.
abstract: Common obstetric interventions are often for "convenience" rather than for clinical indications. Before proceeding, it should be clear who is the beneficiary of the convenience. The primary healthcare provider must make sure that women and their partners have a full understanding of what is known about the associated risks, benefits, and alternative approaches of the proposed intervention. Thorough and accurate information allows women to choose what is best for them and their infant on the basis of the individual clinical situation. Ideally, this discussion takes place during the prenatal period when there is ample opportunity to ask questions, reflect on the potential implications, and confer with partners and family members. A review of common obstetric interventions is provided. While these interventions often are medically indicated for the well-being of mothers and infants, the evidence supporting their benefits when used electively is controversial.
authors.affiliation: St. John's Mercy Medical Center, St. Louis, Mo, USA. KRSimpson@prodigy.net
authors.forename: Kathleen Rice
authors.initials: KR
authors.lastname: Simpson
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Thorman
mesh_terms: D001294:Attitude to Health; D002585:Cesarean Section / Q000009:adverse effects* / Q000451:nursing / Q000592:standards / Q000706:statistics & numerical data; D002755:Choice Behavior; D017558:Elective Surgical Procedures / Q000009:adverse effects* / Q000451:nursing / Q000592:standards / Q000706:statistics & numerical data; D004841:Episiotomy; D019317:Evidence-Based Medicine; D006801:Humans; D007258:Informed Consent; D007751:Labor, Induced / Q000009:adverse effects* / Q000451:nursing / Q000592:standards / Q000706:statistics & numerical data; D017283:Neonatal Nursing / Q000458:organization & administration; D024802:Nurse's Role; D015399:Nursing Research; D009773:Obstetric Nursing / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000193:education / Q000523:psychology; D010344:Patient Advocacy; D010353:Patient Education as Topic; D012307:Risk Factors; D014481:United States; D019564:Unnecessary Procedures / Q000009:adverse effects* / Q000451:nursing / Q000592:standards / Q000706:statistics & numerical data