In many hospitals the answer to a complicated preterm delivery is a caesarean section, but is this really in the best interests of the mother and baby? We will briefly discuss the ethics of caesarean section with regard to viability and the place for caesarean section on demand. We will then review the literature and evaluate what is best for both mother and baby when delivery of an extremely low-birth-weight infant is inevitable. Over the past few decades there has been a sharp rise in the caesarean section rate. (1) This rise has been disproportionate to obstetric indications. Possible reasons for the rise are the concerns of litigation, the convenience of caesarean section for both patient and practitioner, and possibly the downward shift of the threshold of viability for the fetus.
