Maternal Request Caesarean Sections and Medical Necessity
Title: Maternal Request Caesarean Sections and Medical Necessity
Abstract: Currently, many women who are expecting to give birth have no option but to attempt vaginal delivery, since access to planned or elective caesarean sections in the absence of what is deemed to constitute ‘clinical need’ is variable. In this paper, we argue that maternal request caesarean sections (MRCS) – those performed at the request of the woman, in the absence of clinical indication – should be routinely offered to pregnant women. We argue that MRCS is a medically reasonable option, and this should suffice to make it appropriate to offer it to women with low risk pregnancies. We further argue that medical necessity is not a particularly helpful concept here, since it fails to identify cases where caesarean section should and should not happen. Given that all forms of childbirth are associated with some form of injury, we argue that birthing women should be given the opportunity to choose which injury they (expect to) suffer during delivery. We consider a number of objections, such as the argument that patients have a right to refuse, but never to demand treatment, and that routinely offering MRCS would be unaffordable for healthcare systems. We do not find that these objections provide compelling reasons not to routinely offer MRCS as a birth option for pregnant women.
Venue: Oxford Uehiro Centre, Suite 1 Littlegate House, 16-17 St Ebbe’s Street, Oxford OX1 1PT (buzzer 1)
Booking: not required (Zoom link available on request).