Patient Choice Cesarean Position Statement

The International Cesarean Awareness Network (ICAN) Opposes Elective Cesarean Section


A recent editorial by Dr. W. Benson Harer, Jr., President of the American College of Obstetricians and Gynecologists, suggests that pregnant women should be given the "right to choose" major abdominal surgery (cesarean section) or a normal, vaginal birth. Dr. Harer claims that elective cesarean section and vaginal birth are equally safe and therefore, either option should be made available to women.


The International Cesarean Awareness Network opposes the use of cesarean section where there is no medical need. Birth is a normal, physiological process. Cesarean section is major abdominal surgery which exposes the mother to all the risks of major surgery, including a higher maternal mortality rate, infection, hemorrhage, complications of anesthesia, damage to internal organs, scar tissue, increased incidence of secondary infertility, longer recovery periods, increase in clinical postpartum depression, and complications in maternal-infant bonding and breastfeeding, as well as risks to the infant of respiratory distress, prematurity and injuries from the surgery.


Many of the long-term complications of vaginal birth that Dr. Harer lists (urinary incontinence, uterine and bladder prolapse) can be prevented by improved labor and birth techniques. For example, episiotomies are associated with pelvic floor damage and long-term complications. They have also been proven to be unnecessary and harmful in most births, yet the majority of American women are still subjected to this surgical procedure during a vaginal birth.


It has been suggested that cesarean section is the safer method of birth for infants. However, scientific evidence proves that infant outcome does not improve once the cesarean rate climbs above 10 percent.


All physicians take an oath to "Do no harm". This means choosing the path of least risk to patients. Medically unnecessary elective cesareans increase risk to birthing women. It is unethical and inappropriate for obstetricians to perform unnecessary surgery on a healthy woman with a normal pregnancy.


ICAN supports women's rights to accurate, complete, evidence-based medical information; women's right to the best and safest medical care in childbirth in situations where medical care is actually needed in childbirth. ICAN will continue to work to protect women's rights to ethical and appropriate care in childbirth.


ICAN is a nonprofit organization that is working to lower the rate of unnecessary cesarean sections and provide information and support to women healing from past birth experiences and preparing for future births.


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