NCQA (USA), NICE (UK) and SOGC (Canada)

We now know that much of the data pointing to negative cesarean birth outcomes largely relates to emergency surgeries and planned surgeries performed for medical reasons; the risks for a healthy woman planning surgery are less severe and not demonstrably greater than attempted vaginal delivery for women planning small families. Nor are major fetal risks demonstrably greater when delivered at 39-40 weeks.

Similarly, it is also increasingly evident that planned cesarean finances are not equal to emergency procedures (the costs of which largely belong with the planned vaginal deliveries' account), and that a more exact calculation of planned vaginal delivery and planned cesarean delivery cost and outcomes would be useful.

Just as there are women who choose to deliver their babies at home, there are also women at the other end of the choice spectrum for whom planned surgery is their preferred birth plan, and increasingly, obstetricians are supporting their choice. However, many public health groups, insurance companies and individual hospitals - preoccupied with reducing a rising national cesarean rate linked more to increasing maternal age, incidence of obesity and repeat cesareans than to maternal request - are discouraging and even refusing cesarean choice.

Contrary to some of the more negative media interpretations, these women are not seeking to schedule surgery around their pedicures and manicures (it's an insult to women and indeed the doctors who deliver their babies to suggest that), but rather to ensure (in their opinion) the safest outcome for their babies and themselves. For some, there is no medical indication (they have simply evaluated the risks and benefits of both vaginal and cesarean delivery and chosen the potential outcomes most acceptable to them), while for others, they may be diagnosed with tokophobia or have endured a previous traumatic delivery.

We, the undersigned, call on the National Committee for Quality Assurance (NCQA), the National Institute for Health and Clinical Excellence (NICE), and the Society of Obstetricians and Gynaecologists of Canada (SOGC) to recognize planned, prophylactic cesarean delivery at confirmed 39-40 weeks gestation as a legitimate birth choice for healthy pregnant women (planning a small family) who want to avoid the unpredictable nature of vaginal delivery with all its potential outcomes (including an emergency cesarean) and associated risks (for mother and baby), and prefer instead to accept the risks associated with planned surgery.

Important note:- This petition advocates cesarean choice as opposed to advocating cesarean delivery for all women.

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The Prophylactic cesarean delivery is a legitimate birth choice petition to NCQA (USA), NICE (UK) and SOGC (Canada) was written by Pauline McDonagh Hull and is in the category Health at GoPetition.