Cesarean delivery rates have been steadily increasing worldwide. In response, many countries have introduced target goals to reduce rates. But a focus on target goals fails to address practices embedded in standards of care that encourage, rather than discourage, cesarean sections. Obstetrical standards of care normalize use of technology, creating an imperative to use technology during labor and birth. A technological imperative is implicated in rising cesarean rates if physicians or patients fear refusing use of technology. Reproductive autonomy is at stake since a technological imperative undermines patients’ ability to choose cesareans or refuse use of technology increasing the likelihood of cesareans. To address practices driven by a technological imperative I outline three physician obligations that are attached to respecting patient autonomy. These moral obligations show that a focus on respect for autonomy may prove not only an ideal ethical response but also an achievable practical response to lowering cesarean rates.
Open Peer Commentaries.
- The Importance of Risk Tolerance in Maternal Autonomy
- Beyond Numbers: The Multiple Cultural Meanings of Rising Cesarean Rates Worldwide
- Where Are the Midwives?
- Increasing Cesarean Rates: The Balance of Technology, Autonomy, and Beneficence
- Relational Autonomy on the Cutting Edge
- Reproductive Autonomy and Normalization of Cesarean Section