Leeman Lawrence M, Plante Lauren A
Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA.
Ann Fam Med. 2006 May-Jun;4(3):265-8. doi: 10.1370/afm.537.
Patient-choice cesarean delivery is increasing in the United States. The American College of Obstetricians and Gynecologists supports this option, citing ethical premises of autonomy and informed consent, despite a lack of evidence for its safety. This increase in patient-choice cesarean delivery occurs during a time when women with a breech-presenting fetus or a previous cesarean section have fewer choices as to vaginal birth. Patient-choice cesarean delivery may become widely disseminated before the potential risks to women and their children have been well analyzed. The growing pressure for cesarean delivery in the absence of a medical indication may ultimately result in a decrease of women's childbirth options. Advocacy of patient-choice requires preserving vaginal birth options as well as cesarean delivery.
在美国，患者自主选择剖宫产的情况日益增多。美国妇产科医师学会支持这一选择，理由是自主和知情同意的伦理前提，尽管缺乏其安全性的证据。在臀位胎儿或曾行剖宫产的女性选择阴道分娩的机会减少之际，患者自主选择剖宫产的情况却在增加。在对女性及其子女的潜在风险进行充分分析之前，患者自主选择剖宫产可能就已广泛传播。在没有医学指征的情况下，剖宫产的压力不断增加，最终可能导致女性分娩选择的减少。倡导患者自主选择需要保留阴道分娩和剖宫产这两种选择。
