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Please stop using the adjective “elective” to describe the important health services ObGyns provide

OBG Management. 2020 October;32(10):8-9 | doi: 10.12788/obgm.0041
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Calling a health intervention “elective” risks miscommunicating that it is unnecessary or should have a lower priority than “indicated” interventions. We can avoid this confusion if we discontinue the use of “elective” to describe ObGyn procedures.

Time for change

Shockingly, in searching the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD10), the word elective is most commonly used in the context of health services provided to pregnant women, including: elective induction of labor (Z34.90), elective cesarean delivery (O82), elective termination of pregnancy (Z33.2), and elective fetal reduction (Z031.30X0). In ICD10, other specialties do not describe the scope of their health services with the adjective elective.

There are many definitions and interpretations of elective. The most benign use of the word in the context of surgery is to contrast procedures that can be scheduled in the future with those that need to be performed urgently. In this context elective only refers to the timing, not the medical necessity, of the procedure. By contrast, describing a procedure as elective may signal that it is not medically necessary and is being performed based on the capricious preference of the patient or physician. Given the confusion and misunderstanding that may be caused by describing our important health services as “elective,” I hope that we can permanently sunset use of the term. ●