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19B - All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section

Against

from Section III - The Best Policy

Published online by Cambridge University Press:  25 November 2021

Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
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Summary

‘First do no harm.’ Caesarean section has been normalised in a world where birth trauma, bad outcomes and pain are seen as unacceptable despite being a historical reality of child-bearing. In a society where it is increasingly easy to control most aspects of life, labour and childbirth remain a difficult and unpredictable process. Anxiety surrounding this is high amongst pregnant women but also their care providers who are responsible for the outcomes of both mother and child and who also carry personal risk in this litiginous era. This anxiety seems even more prevalent in pregnancies that were difficult to achieve and long-awaited. One challenge of caring for the pregnant woman in the NHS as well as many other international healthcare systems is the lack of continuity of care. Many obstetricians and midwives will not see women in their next pregnancy or into their following stages of life. They are not responsible for the returning patient with the morbidly adherent placenta or the woman requiring pelvic surgery later in life in whom surgical adhesions make the procedure significantly more dangerous.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2021

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References

National Institute for Clinical Excellence (NICE). Caesarean section Clinical guideline [CG132] Published date: November 2011 Last updated: September 2019.Google Scholar
MacDorman, MF, Menacker, F, Declercq, E. Cesarean birth in the United States: epidemiology, trends, and outcomes. Clin Perinatol. 2008;35(2):293307.CrossRefGoogle ScholarPubMed
Pandey, S, Shetty, A, Hamilton, M, Bhattacharya, S, Maheshwari, A. Obstetric and perinatal outcomes in singleton pregnancies resulting from IVF/ICSI: a systematic review and meta-analysis. Hum Reprod Update. 2012;18(5):485503.CrossRefGoogle ScholarPubMed
Cromi, A, Marconi, N, Casarin, J, et al. Maternal intra‐ and postpartum near‐miss following assisted reproductive technology: a retrospective study. BMJ. 2018; 125:12.Google ScholarPubMed
Szymusik, I, Kosinska-Kaczynska, K, Krowicka, M, et al. Perinatal outcome of in vitro fertilization singletons – 10 years’ experience of one center. Arch Med Sci. 2019;15(3):666–72.CrossRefGoogle ScholarPubMed

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