Primary elective Cesarean Section is safer for infant and mother
Preferred above Emergency C-section
Possible resolutions – Evidence based studies should be conducted
Ethical dilemmas appear as moral conflicts everyday in nursing practice interventions. The anticipation of every nurse is that one day while engaged in this vocation an ethical dilemma will surface. Contemporary nursing practice forces the nurse to be a patient advocate also, besides execution of daily tasks to enhance life. Maternal infant nursing, as any other part of the discipline form time to time, forges ethical considerations at all levels of practice. In this discourse the writer will advance an argument for primary elective caesarean section and how an ethical dilemma can emerge when a woman and her family requests this surgical intervention without any apparent indication. Importantly, this is a rising concern among obstetricians in the profession, today.
Maternal Infant Nursing: Elective Primary Cesarean Section
Introduction
Impositions socially and equally in contemporary obstetrical practice are forging obstetricians and obstetric nurses to consider the value of primary elective cesarean section when there are no obvious medical or obstetrical indications according to the ethical protocol for such surgical intervention. The argument advanced for endorsing this practice is that there is no supporting evidence based practice indicative that vaginal delivery is better than cesarean section (Turner, Young , Solomon , Ludlow , Benness & Phipps, 2006) .
More importantly, activists promoting this assumption contend that it is ethically acceptable since a 5 minute elective C- section preceded by a trial of labor is much safer for the fetus since the presenting part would escape the trauma of labor (Lavender & Kingdon, 2009) Therefore, in outlining the ethical implications of primary elective C- section the writer will advance that it is safer for both mother and infant; it is a necessary intervention above emergency C-section and as twenty first century practitioners it is time that research be conducted supportive of this practice.
Primary elective Cesarean Section is safer for infant and mother
The ethical dilemma facing this profession is when mothers and their partners or husbands argue for primary elective cesarean sections. Subtle speculations are that some obstetricians encourage this practice due to the increased cost as against a vaginal delivery. Certainly, this shows another face of the dilemma if this is proven to be true. However, Dr. Robert K. DeMott, private practice obstetrician-gynecologist and vice president of medical affairs at Bellin Hospital in Green Bay, Wisconsin considered this accusation outrageous to confirm that the majority of obstetricians would not consent to primary C-section if not indicated even though scientifically the practice can be endorsed as safer. So far it is against professional ethics (DeMott, 2008)
Preferred above Emergency C-section.
After conducting a pelvic assessment and monitoring infant and mother for over six hours, nurses and doctors should be able to predict the outcome of labor. Why allow a mother to labor beyond twelve hours and then order emergency C- section? This in itself can be considered unethical since there could be evidence of fetal hypoxia and maternal distress. The complications of lifting a deeply embedded presenting part out of the pelvis could be catastrophic (Pakenham, Chamberlain & Smith, 2006).
Possible resolutions – Evidence based studies should be conducted
When the pros and cons of primary elective C-section are weighed, it would appear that it is more unethical to withhold primary elective C- section requests from a family even in the absence of no prevailing indication. It is less painfully and complications are less likely for both mother and infant. The solution to this ethical dilemma then, lies in encouraging research which will offer resolutions and there would be a scientific evidence approach towards an emerging alternative within the discipline.
Conclusion
The foregoing paragraphs discussed an ethical dilemma facing professionals regarding requests for primary elective C-sections, to conclude that in the absence of evidence based data supportive of this advancement it is unethical, but can be resolved when studies are conducted to support speculations.
References
DeMott, Robert (2008). Should primary elective cesarean section be performed on demand in the absence of medical indications? Gale. Cenagage Learning
Lavender T, Kingdon C (2009). “Primigravid women's views of being approached to participate in a hypothetical term cephalic trial of planned vaginal birth versus planned cesarean birth.” Birth. 36(3):213-9
Pakenham S, Chamberlain M, Smith N (2006). “Women's views on elective primary caesarean section.” J Obstet Gynaecol Can. 28(12):1089-94.
Turner CE, Young JM, Solomon MJ, Ludlow J, Benness C, Phipps H (2006). “Vaginal delivery compared with elective caesarean section: the views of pregnant women and clinicians” BJOG. 115(12):1494-502.
