Cesarean delivery on maternal request Author Errol R Norwitz, MD, PhD Section Editor Charles J Lockwood, MD, MHCM Deputy Editor Vanessa A Barss, MD, FACOG Disclosures: Errol R Norwitz, MD, PhD Consultant/Advisory Boards: Hologic [Preterm birth testing (Fetal fibronectin test to predict preterm birth)]; Natera [Fetal aneuploidy screening (NIPT as a screening test for fetal aneuploidy)] Patent Holder: Bayer [Use of urinary angiogenic factors to predict preeclampsia (Prediction test for preeclampsia)] Charles J Lockwood, MD, MHCM Nothing to disclose Vanessa A Barss, MD, FACOG Employee of UpToDate, Inc Contributor disclosures are reviewed for conflicts of interest by the editorial group When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence Conflict of interest policy All topics are updated as new evidence becomes available and our peer review process is complete Literature review current through: Dec 2014 | This topic last updated: Oct 17, 2014 INTRODUCTION — Cesarean delivery on maternal request (or “on demand”) refers to a primary cesarean delivery performed because the mother requests this method of delivery in the absence of standard medical/obstetrical indications for avoiding vaginal birth A woman’s right to be actively involved in choosing the route of her delivery is now widely accepted by clinicians and patients [1-3] In a well-informed patient, performing a cesarean delivery on maternal request is considered medically and ethically acceptable; in-depth reviews of the ethical issues are available elsewhere [1,2,4-9] However, obstetricians are not obliged ethically or professionally to perform these procedures Early referral to another healthcare practitioner is appropriate in such cases [1] PREVALENCE — Estimates of the prevalence of cesarean delivery on maternal request range from to 18 percent of all cesarean deliveries worldwide, and