Brown Rebecca Ch, Mulligan Andrea
Oxford Uehiro Centre for Practical Ethics, Oxford, UK.
School of Law, Trinity College, Dublin 2, Ireland.
Clin Ethics. 2023 Sep;18(3):312-320. doi: 10.1177/14777509231183365. Epub 2023 Jun 26.
Currently, many women who are expecting to give birth have no option but to attempt vaginal delivery, since access to elective planned caesarean sections (PCS) in the absence of what is deemed to constitute ‘clinical need’ is variable. In this paper, we argue that PCS should be routinely offered to women who are expecting to give birth, and that the risks and benefits of PCS as compared with planned vaginal delivery should be discussed with them. Currently, discussions of elective PCS arise in the context of what are called ‘Maternal Request Caesarean Sections’ (MRCS) and there is a good deal of support for the position that women who request PCS without clinical indication should be provided with them. Our argument goes further than support for acceding to requests for MRCS: we submit that healthcare practitioners caring for women with uncomplicated pregnancies have a positive duty to inform them of the option of PCS as opposed to assuming vaginal delivery as a default, and to provide (or arrange for the provision of) PCS if that is the woman's preferred manner of delivery.
目前，许多待产妇女别无选择，只能尝试顺产，因为在没有被视为构成“临床需求”的情况下，能否进行选择性剖宫产（PCS）存在差异。在本文中，我们认为应该为待产妇女常规提供剖宫产，并且应该与她们讨论剖宫产与计划顺产相比的风险和益处。目前，选择性剖宫产的讨论出现在所谓的“产妇要求剖宫产”（MRCS）的背景下，并且有很多人支持这样的观点，即应该为那些没有临床指征而要求剖宫产的妇女提供剖宫产。我们的观点比支持同意产妇要求剖宫产更进一步：我们认为，照顾无并发症妊娠妇女的医护人员有积极的责任告知她们有剖宫产这一选择，而不是默认顺产，如果这是产妇首选的分娩方式，应为其提供（或安排提供）剖宫产。
