Cesarean delivery

Abstract

Cesarean delivery is defined as the delivery of a fetus through surgical incisions made through the abdominal wall (laparotomy) and the uterine wall (hysterotomy). Because the words "cesarean" and "section" are both derived from verbs that mean to cut, the phrase "cesarean section" is a tautology. Consequently, the terms "cesarean delivery" and "cesarean birth" are preferable. Cesarean deliveries were initially performed to separate the mother and the fetus in an attempt to save the fetus of a moribund patient. This operation subsequently developed into a surgical procedure to resolve maternal or fetal complications not amenable to vaginal delivery, either for mechanical limitations or to temporize delivery for maternal or fetal benefit. The cesarean delivery has evolved from a vain attempt performed to save the fetus to one in which physician and patient both participate in the decision-making process, striving to achieve the most benefit for the patient and her unborn child. Currently, cesarean deliveries are performed for a variety of fetal and maternal indications (see Indications). The indications have expanded to consider the patient's wishes and preferences. Controversy surrounds the current rates of cesarean delivery in developed countries and its use for indications other than medical necessity.