Elective delivery before 39 weeks' gestation: reconciling maternal, fetal, and family interests in challenging circumstances

J Clin Ethics. 2012 Fall;23(3):241-51.

Abstract

We present the case of a 36-year-old woman who has experienced three lost pregnancies; during the most recent loss, a full term pregnancy, she almost died from complications of placental abruption. She is now completing the 34th week of gestation and is experiencing symptoms similar to those under which she lost the previous pregnancy. Despite a lack of specific medical indications, the patient and her husband firmly but politely request that the attending obstetrician/perinatologist perform an immediate cesarean section in order to alleviate the couple's anxiety about possibly never having a family. Discussing the case are an experienced perinatologist, a neonatologist, a regional perinatal center coordinator, and a clinical ethicist.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Spontaneous
  • Abruptio Placentae / prevention & control
  • Adult
  • Cesarean Section*
  • Choice Behavior / ethics
  • Cognition
  • Decision Making / ethics*
  • Emotions
  • Ethics Consultation* / standards
  • Family*
  • Female
  • Fetal Death
  • Health Care Costs
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Intensive Care, Neonatal* / economics
  • Intensive Care, Neonatal* / methods
  • Male
  • Parents* / psychology
  • Patient Care Team* / ethics
  • Persons with Disabilities
  • Physician-Patient Relations / ethics*
  • Pregnancy
  • Premature Birth* / economics
  • United States