How does a wish work

Caesarean section on request: pros and cons

Often there are no compelling reasons for a caesarean section

So can every woman simply wish for a caesarean section? No, because: "The health insurance companies do not pay for any desired Caesarean sections," says midwife Professor Mechthild Groß, head of the Midwifery Science Group at the Hanover Medical School. The doctor must therefore give a valid reason for the caesarean section. Sometimes there are reasons that speak for it, but do not make the caesarean section absolutely necessary. "This is often a combination of several factors. The personal fear and bad experiences that the pregnant woman's circle of acquaintances have had can play a role in this," says Groß. In principle, a vaginal birth would be possible.

Nevertheless, it is not advisable for the doctor to urge the pregnant woman to give birth naturally against her will: "If something goes wrong, an expert could criticize why a caesarean section was not performed earlier or from the start," says Professor Ernst Rainer Weissenbacher, attending physician in the gynecological clinic Dr. Geisenhofer at the English Garden in Munich.

Why women choose to have a caesarean section:

  • Age: Today women often become mothers later. To limit potential age-related risks, some prefer to have a caesarean section. The risk for the mother of dying during the procedure is tiny, but still two to three times higher than with a natural birth. However, emergency interventions are particularly risky - planned caesarean sections are in comparison safer here.
  • Child welfare: In contrast, the risk of complications in babies with a caesarean section is about two to three times lower. "That is crucial for many women," says Weissenbacher.
  • Fear of perineal rupture and incontinence: Many women want to remain intact in the genital area or fear a weak pelvic floor. Researchers at the Royal Infirmary of Edinburgh actually found that a caesarean section rather than a natural delivery can lower the risk of incontinence and pelvic floor problems in the long term.
  • Fear of labor: "Some mothers have vague fears, some do not want to deal with the birth process," says Mechthild Groß. The midwife is very critical of this attitude. It is important that the parents-to-be consider their future role. "In such cases, I will at least require a certificate of antenatal class before I consent to the caesarean section."
  • Plannability: According to Weissenbacher, the ability to plan the due date hardly plays a role. "Even a desired caesarean section cannot be planned very precisely: emergency caesarean sections take place in the clinic."