title: Indications for cesarean section on maternal request--guidelines for counseling and treatment.
abstract: OBJECTIVE
  The aim was to find scientific evidence and, based on this, to develop national medical guidelines in Sweden for cesarean section on mother's request.
  
  
  BACKGROUND
  More than 17% of all births in Sweden in 2008 were cesarean sections, compared to 5% at the beginning of the 1970s. About 8% of the cesarean sections were performed at mother's request. The predominant reason for this preference is fear of childbirth. When deciding whether to perform an elective cesarean section, the obstetrician must emphasize the long- and short-term health consequences for the mother and her baby, as well as weigh the risks associated with the procedure itself against not performing the procedure. Clarification is needed to determine for which conditions it is appropriate to comply with the mother's request.
  
  
  METHODS
  A literature review was conducted to identify factors that were relevant as an argument to meet the request for cesarean section on maternal request. The authors analyzed these factors individually to determine.
  
  
  RESULTS
  The guidelines suggest that it is appropriate to comply with a woman's request for cesarean section if the reason for her request is deemed sufficiently serious and if, after participating in a counseling program, the woman persists in her request for cesarean section.
  
  
  CONCLUSIONS
  A request for cesarean section where no medical indication is present should not be met without considerations concerning the safety of the mother and her baby, while also weighing the risk of adverse outcomes for mother and baby.
authors.affiliation: Division of Obstetrics and Gynaecology, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.ingela.wiklund@bbstockholm.se
authors.forename: Ingela
authors.initials: I
authors.lastname: Wiklund
authors.forename: Ellika
authors.initials: E
authors.lastname: Andolf
authors.forename: Håkan
authors.initials: H
authors.lastname: Lilja
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Hildingsson
mesh_terms: D002585:Cesarean Section; D003376:Counseling; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D013548:Sweden