Nursing implications of the 2006 NIH State of the Science Conference Statement: Cesarean Delivery on Maternal Request.

Will the nation's higher rate of cesarean deliveries (CDs) (over 29%) lead to increased health risks for mothers and their babies? In March 2006, a National Institutes of Health State of the Science Conference was convened to assess available research on the topic. The focus was to identify outcomes from research studies addressing "cesarean delivery on maternal request" (CDMR), defined as CD without a medical indication for either the mother or the fetus. This conference concluded that it is currently unknown whether CDMR is really a trend in the United States, or whether the emergence of this phenomenon is associated with any specific benefits and harms to mothers and babies. More research is needed to determine if a trend exists. On the basis of systematic review of studies, no "strong quality-evidence" was found comparing CD and normal vaginal delivery outcomes. Future research was recommended to develop studies for this purpose in areas such as placental abnormalities (placenta previa and accreta) and various neonatal outcomes. Research on "modifiable" factors during labor and delivery which might decrease maternal and neonatal complications, including the risk for future pelvic floor disorders, was also recommended in the 2006 Conference Statement.