{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:21:28Z","timestamp":1793042488931,"version":"4.5.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The obstetrics field is undergoing transformation and committing to ensuring the autonomy of pregnant women in decisions related to birth based on scientific information. The physiological process of birth typically results in vaginal delivery, but medicine has evolved to include obstetric surgeries that are safe and result in few perioperative complications, especially when cesarean section is performed from 39 weeks of gestational age. Thus, the question is whether clinicians should interfere with pregnant women\u2019s freedom to choose their mode of delivery by trying to persuade them to choose vaginal delivery. The objective was to analyze the perinatal complications of the maternal\u2013fetal dyad in primiparous women subjected to vaginal delivery versus elective cesarean section with respect to the bioethical precepts of autonomy, beneficence and nonmaleficence. In total, 2,507 women, including 1,807 (72.1%) with vaginal deliveries and 700 (27.9%) with cesarean deliveries, were analyzed between 2017 and 2020. There was no difference between the types of delivery in maternal readmission, death, admission to the intensive care unit, an Apgar score &lt;7 in the 5th minute of life, maternal blood transfusion or comorbidities of the mothers or newborns. The elective cesarean section group showed less need for therapeutic uterotonics. In primigravidae, it was observed that elective cesarean section did not present a higher risk of complications than vaginal delivery. Therefore, this guarantees the autonomy and right of the individual to choose the mode of delivery.<\/jats:p>","DOI":"10.1371\/journal.pone.0292846","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T17:28:53Z","timestamp":1697563733000},"page":"e0292846","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Perinatal complications of the maternal\u2013Fetal dyad in primiparous women subjected to vaginal delivery versus elective cesarean section: A retrospective study of clinical results associated with bioethical precepts"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4867-5878","authenticated-orcid":true,"given":"Carlos Henrique","family":"Mascarenhas Silva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udia Lourdes","family":"Soares Laranjeira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5884-6565","authenticated-orcid":true,"given":"Carolina Soares","family":"Barros de Melo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena Ventura","family":"Brand\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela Costa","family":"Oliveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto Henrique Fulg\u00eancio","family":"Brand\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Nunes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"issue":"4","key":"pone.0292846.ref001","article-title":"Childbirth care in Health services affiliated with the stork network in Brazil: the users perspective","volume":"38","author":"AL Nunes","year":"2022","journal-title":"Cad Saude Publica"},{"issue":"5","key":"pone.0292846.ref002","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1111\/1471-0528.13750","article-title":"Promoting respect and preventing mistreatment during childbirth","volume":"123","author":"JP Vogel","year":"2016","journal-title":"BJOG"},{"issue":"6","key":"pone.0292846.ref003","doi-asserted-by":"crossref","first-page":"92","DOI":"10.21315\/mjms2017.24.6.11","article-title":"Evaluating the concept of choice in healthcare","volume":"24","author":"Z Yusrita","year":"2017","journal-title":"Malays J Med Sci"},{"issue":"5","key":"pone.0292846.ref004","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.wombi.2017.03.007","article-title":"Women\u2019s attitudes toward the medicalization of childbirth and their associations with planned and actual modes of birth","volume":"30","author":"Y Benyamini","year":"2019","journal-title":"Women Birth"},{"key":"pone.0292846.ref005","first-page":"e180487","article-title":"Physicians\u2019 perception of obstetric or institutional violence in the subtle dimension of the human and physician-patient relationship","volume":"23","author":"MM Sens","year":"2019","journal-title":"Interface (Botucatu)"},{"key":"pone.0292846.ref006","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1111\/j.0001-6349.2004.0312.x","article-title":"Danish obstetricians\u2019 personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey","volume":"83","author":"T Bergholt","year":"2004","journal-title":"Acta Obstet Gynecol Scand"},{"key":"pone.0292846.ref007","first-page":"1","article-title":"Is it decision of women to choose a cesarean section as the mode of birth? 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