Grant: Catalyst Grant: Maternal and Child Health

Cesarean delivery on maternal request is defined as a primary cesarean delivery at maternal request in the absence of any medical or obstetric indication by The National Institutes of Health and American College of Obstetricians and Gynecologists. A potential benefit of cesarean delivery on maternal request is decreased risk of hemorrhage for the mother. Potential risks of cesarean delivery on maternal request include a longer maternal hospital stay, an increased risk of respiratory problems for the baby, and greater complications in subsequent pregnancies, including uterine rupture and placental implantation problems. However, the magnitude of cesarean delivery on maternal request is difficult to quantify. There is insufficient evidence to evaluate fully the benefits and risks of cesarean delivery on maternal request compared with planned vaginal delivery, and more research is needed. The proposed study will use the Niday database which is part of the Ontario Perinatal Surveillance System and includes more than 95% of births in Ontario. The Database includes information on the number of women giving birth and babies born in the province, maternal and prenatal factors, health services factors, intrapartum interventions, birth outcomes and infant health. We will identify characteristic factors related to cesarean delivery on request and compare the outcomes between cesarean delivery on maternal request and planned vaginal delivery. Clinicians would benefit from strong evidence regarding risks and benefits, evidence that is crucial to guiding policy making with regard to cesarean delivery on maternal request. If this study finds that no major differences between primary cesarean delivery on maternal request and planned vaginal delivery, a decreasing cesarean section rate will relieve an economic burden on highly stressed medical systems and increase patient satisfaction.