Elective Primary Caesarian Section
Expectant parents prepare in advance for the arrival of their baby long before delivery. As part of the preparation, the expecting family decorates the nursery, shop for clothes and diapers and some go an extra mile of determining the method of delivery long before labor pains occur. When the day of delivery comes, the family has a preconceived idea of how their child will be delivered. While most families are contented with the natural birth method, some couples are ready for Cesarean section, which was initially a reserve of emergency cases threatening the life of the mother or unborn baby. The recent trends (Stannard, 2008) reveal that many mothers finds C-section to be more acceptable to them than labor pains associated with natural birth. According to Kalish et. al., there are three salient issues related to elective primary caesarian section (Kalish, McCullough and Chervenak, 2008). First, the medics ponder whether delivery through caesarian section is consistent with generally accepted good professional medical practice. Secondly, in what manner should physician respond to expectant mothers who choose to have c-section and finally, should the c-section delivery be made available to all pregnant mothers regularly? All these questions dictate the acceptability of elective c-section regardless patient’s decision.
Giving Pain Medications during Labor
Upon the expiry of nine months pregnancy, potential mothers anticipate a period punctuated by intense pain culminating in the expulsion of newborn. The pain accompanying this process is referred to as labor. The intense pain may prompt physicians to administer pain-relieving drugs, thus opening room for another controversial ethical issue. Another ethical dilemma facing physicians in the execution of their duties is the use of pain relieving drugs during labor. The ability of mothers in labor to make well-reasoned healthcare decision, including accepting the option to go through potentially invasive treatment is a serious ethical concern in obstetric anesthesia. The most controversial ethical dilemma is the timing of consent seeking to relieve peridural labor analgesia. In such a case, there is a possibility of pain clouding the patient’s ability to make a rational decision. In addition, the use of such substances like opioids in any form of labor analgesia may distort the ability of a patient, in whom the substance has been administered, to make a reasonable judgment regarding tubal legation or cesarean section. Opioid has the potential of hampering cognitive function in retrieval of secondary memory (Hanks and O'Neill, 1995). The threat of hampering subsequent cognitive reasoning of a patient is a serious ethical dilemma facing the use of pain relieving drugs during labor (Veselis and Reinsel, 1994). Ideally, physician is supposed to alleviate suffering and pain in his patients. However, the resultant dilemma associated with this may call for complete neglect of obstetric anesthesia.
For a suitably informed mother, performance of caesarian delivery and administration of obstetric anesthesia is both ethically and medically acceptable. Medical personnel should advice against unnecessary cesarean delivery whenever obstetrician does not recommend the method regardless of patient’s advocacy for the same. Although it has become a modern day norm for medics to accede to a well-informed mother’s request to have elective caesarian section, it does not imply that obstetricians may give elective c-section to all pregnant women.
In summary, whenever a patient places an intention of having elective caesarian delivery, obstetricians on their capacity as advocates of patients, are supposed to assist in guiding their patients understand myriad of constraints informing the decision which will eventually respect both the physician's duty to ensure the safety of both the newborn and its mother and patients autonomy. The satisfaction of these conflicting constraints represents an ideal elective caesarian section without a trace of ethical dilemma.