Should Your ObGyn Do a Cesarean Delivery Without a Medical Indication If You Request It?
Improve Your Obstetric Intelligence: Understanding Your Choices and Rights in Childbirth
As a doctor who's helped thousands of women have babies, I often get asked: "Can I choose to have a C-section even if I don't medically need one?" This is an important question that touches on your rights, safety, and the birth experience you want.
What Is a "Requested" C-Section?
When a pregnant woman asks for a C-section without any medical reason, doctors call this a "Cesarean Delivery on Maternal Request" or CDMR. This is different from C-sections done because of medical problems like a baby in the wrong position or issues with the placenta.
About 2-3 out of every 100 births in the U.S. happen this way. While that might not sound like many, it adds up to thousands of births each year.
Why Some People Choose This Option
There are many valid reasons why someone might ask for a C-section:
Fear of pain during vaginal birth
Worry about tearing or damage to the pelvic floor
A bad experience with a previous vaginal birth
Wanting to know exactly when the baby will be born
Concern about the baby getting stressed during labor
Family or cultural influences
Studies show that women who get their preferred type of birth—whether vaginal or C-section—tend to feel better about their experience afterward.
What Science Tells Us About the Risks and Benefits
Like any major decision in healthcare, there are pros and cons to consider:
For the pregnant woman:
C-sections are major surgery with longer recovery time
There's more risk of infection and bleeding
Future pregnancies might be more complicated
There's less risk of certain pelvic floor problems
You avoid labor pain and the unpredictability of labor
For the baby:
More breathing problems can happen, especially if the C-section is done before 39 weeks
Less chance of certain injuries that can happen during vaginal birth
Differences in how the baby's immune system develops
What makes this tricky is that the risks and benefits aren't the same for everyone. Your health history, body, and personal situation all matter.
What Do Medical Organizations Say?
The American College of Obstetricians and Gynecologists (ACOG)—the main organization for doctors who deliver babies—says that vaginal birth is generally safer when there's no medical reason for a C-section. However, they also say that after a thorough discussion, if a patient still wants a C-section, doctors should respect that choice.
How Your Doctor Should Handle Your Request
In my practice, when a woman asks for a C-section, I:
Ask about her reasons and listen carefully
Talk about her specific worries using easy-to-understand facts
Discuss other options (like better pain control or having a support person in labor)
Explain the risks and benefits for her specific situation
Make sure she understands all the information before deciding
Finding What's Right for You
I've learned that when a woman asks for a C-section, there's usually an important concern behind it. Sometimes, talking through those concerns helps women change their minds. Other times, it confirms that a C-section really is what they want.
There's no one-size-fits-all answer here. The most important thing isn't whether doctors should always say yes or no to these requests. It's about having honest conversations where both you and your doctor share information and concerns.
Remember, giving birth is a deeply personal experience. A good doctor will give you clear information, take your concerns seriously, and support your informed choice—even if it's different from what they would recommend.
In the end, the best birth plan is one where you feel heard, respected, and safe, whatever type of delivery you choose.