| Abstract |
For women, their families and health care professionals the birth of
a child is very important. As a multidimensional experience of life, birth has a
deep symbolism for every society. In many scientific articles, we read that
medicine defends Caesarean section, if required by the mother. It is also
referred that an increasing number of women continuously selects to undergo
surgery without any medical reason. The Official Statement of the American
College of obstetricians and gynaecologists supports Caesarean section, in
the name of autonomy, i.e. when women select it.
However, many studies express the concern of Caesarean section
normalization as a choice available for all pregnant women and the
consequences of such standardisation. It is therefore believed that in order to
avoid normal, natural birth, women select surgery. This reflects the inability of
modern society to comprehend the weaknesses of women and help them to
manage pain and fear. As a consequence, Caesarean section is reported as
the practice of medical intervention in the private area of the woman and
foetus that leads to the medicalization of birth.
Under the scope of this controversy, the present work, based on
the principle of autonomy, investigates the ethical aspects of Caesarean on
demand. Precisely, the issues of whether caesarean on demand is a real
autonomy of the patient or whether it reflects the concept of “choice”, as a
result of social management, are discussed. At the same time, the process of
decision-making, regarding the moral principles of bioethics is analyzed, while
emphasis is given in the principle of informed consent.
Within the analysis proposed here, special interest is provided by
the feminist critique in the Caesarean sections on demand, which refers to a
"vehicle" for further social sex discriminations and not for an absolutely free
choice, which would indeed be a product of autonomy. According to this
opinion, women may see Caesarean as one of their achievements, which,
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however, is a process against their real priorities and objectives. On the
contrary, Caesarean section is believed to represent a model of force and
power since giving birth naturally is considered by the society as an obstacle.
The study of the factors leading to the increase of Caesarean
section is also considered. Literature research has shown that most surgeries
take place mainly on Fridays between 6:00 am and 18:00 pm. Such motives
attribute great responsibility to doctors who act according to their comfort and
convenience. At the same time, the consequence to this practice significantly
increases financial costs, in a period of time where the economic hindrances
of insurance services requires a decreased dependence from the health
system.
The present analysis attempts to argue about the preservation of
the right to health, the maintenance of Caesarean section as a choice for
women, the principle of informed consent, as well as all information in favour
and against Caesarean section regarding the health of the foetus and mother,
based on the official statements of institutions, including the Committee of
American College of Obstetricians and Gynecologists, the Canadian
Association of Midwives, the Society of Obstetricians and Gynecologists of
Canada (SOGC) and others. As mentioned in the scientific literature, a
relative argument against the caesarean section appears to be the increased
risk of maternal morbidity and mortality as compared to normal birth.
Caesarean section has been connected to the need of use of the same
procedure in future births, with disturbances in lactation and depression. As a
result, the risk is increased upon consequent surgical interventions,
complicating the terms of good health of the mother.
Consequently, the issue of the Caesarean on demand which
continually increases in our days needs to be examined from the bioethical
viewpoint
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