The rise in Caesarean births cannot be explained by maternal health alone, and it reflects a deeper cultural shift in how we understand pregnancy and the female body.
Two more reasons. In the U.S., at least, providers are paid far more for a Caesarean than for a natural birth. Also, natural births used to be abetted by midwives or nurses, primarily females. Doctors, primarily males, perform Caesareans, thus appropriating what used to be a female function. Same old story.
Sheila Kitzinger's book "Rediscovering Birth" is very good. It compares medicalised and traditional birth patterns. The photos of a hospital where all caregivers are looking at a machine compared to traditional midwifery where all the caregivers are looking at the mother, observing the mother, are very powerful to me. The highly medicalised birth where the power of what's happening is in the hands of those who can read the machines (generally not the mother), compared to the shared knowledge of the traditional setting. I am a mother of 8, and have doula-ed a few times. Women's birth stories are very powerful to them, and on their behalf I resent this being taken away from them by a culture of fear, both within the medical system and across our societies in general. Australia.
I comment as a mother who had two successful VBACs, as a midwife and as a volunteer breastfeeding support worker for over 40 years. I have watched in horror as section rates have risen and VBAC rates have fallen due to the factors you have described here.
If I had to sum this up in one word, it would be "trust" because that is now absent in most Western maternity settings. It's not just an absence of institutional trust in birth; women are now socialized to not trust their own bodies or their own judgement. The "faulty female" reigns in most hospitals and due often to monetary constraints, women are not allowed to labor at their own pace, because everyone has their eyes on the clock.
Yes, women giving birth now are indeed older, fatter and generally unhealthier, but the same factors feed into this too. Women are told they must have everything in place before embarking on pregnancy: fulfilling careers (that they will need to return to), a house and every other thing they "need" before becoming mothers. So, by the time they feel ready to become pregnant they are in their late 30s or even in their early to mid 40s and it comes as a shock to discover that it may not "just happen" for them.
All the young women who are now freezing their eggs courtesy of their employers are in for the crushing disappointment that is inevitable for most of them when they realize that they will never be biological mothers because those fresh, young eggs aren't viable 15 to 20 years later. Funny how the fertility clinics charging yearly fees for egg storage didn't tell them this.
Nearly anything can be medicalized, but this is not always a universal good. Yes, I know that more women and babies died before some common practices started being utilized, but women and babies still die, and sometimes it's because of what we do, not what we don't do.
I believe one of Sheila Kitzinger's books (can't remember off the top of my head) set out to show that the hospital model was safer than the homebirth option. In the end she concludes that they are equally "safe". I've doula-ed at VBACs of a friend's. The doctors worked towards theatre, the original midwife (for her first) had no idea how to care for her apart from watching the machine monitoring her. Thankfully the last midwife (the labouring went over at least two shifts) spoke up for my friend to be able to continue. The midwife had just returned from working with Aboriginal women in Northern Territory, Australia, and was obviously more observant and "connected". My friend went on to have two more VBACs each with less medical intervention, having restored her own sense of empowerment: that she could do it. That was years ago. This last year I attended the hospital birth of my daughter's second child, and I was appalled by "care" of the hospital team: time constraints, fear, so risk-conscious that it interfered with the bonding process, and more.
Over thirty years ago when my children were born, my wife read many caesareans were done in order to schedule a birth rather than having the uncertainty of labour. My question is why should child birth seemingly be hijacked by the medical profession. I agree there are at times the need for medical intervention. But I find it hard to believe over 30% of childbirths let alone the 50% in the UK need such intervention. Women are owed an explanation. Also is there an advantage for the child to undergo a natural birth?
Yes in every way it’s an advantage for a child to undergo a natural birth. One thing I know is the birth canal contains all sorts of healthy bugs which support the baby’s healthy growth and immune system in ways we just can’t know yet.
In the science lab of my own family, my c born twins struggled with low weight all their childhood but my natural born daughter flourished. Coincidence? Maybe. But I don’t think so.
“Good maternity care should begin with confidence in the healthy female body, offering continuity, patience, and skilled support while remaining ready to intervene when genuine complications arise.”
I was lucky enough to give birth to my first child in the Netherlands, where I was repeatedly told this: "Your body was made to do this. You just need to let it do its job – and in the unlikely event that you need intervention, the very best will be available". I was "accompanied" during labour by calm and expert midwives, having had the best possible antenatal preparation. I had no pain relief – it was not given routinely in the Netherlands – but I was allowed to move freely. It was a thoroughly positive experience – no stitches, and a very speedy recovery. I was home hours later, with ongoing support for eight days.
Just letting your body do its job, though, is increasingly seen as undesirable. I have worked with many young women, on multiple medications, who appear determined to stop their bodies functioning naturally in any way at all. Part of this is undoubtedly about a need for control, and an unwillingness to suffer any kind of discomfort, which earlier generations accepted was neither possible nor desirable.
This article would have been credible if it provided statistics. Different historic periods, different areas of the world. C-sections save lives. Conspiracy theories and extreme deductions don't. Women are advised by doctors of risks in the West. They will always decide proactively for preserving the living . No expectant mother wakes up and thinks " you know? I'm gonna have me a C-section ".
Never heard of it. Is there proof that women make such decisions?
I agree with you regarding the importance of providing relevant facts and stats.
However, your comment “No expectant mother wakes up and thinks " you know? I'm gonna have me a C-section ".” is naive. According to the CDC approximately 10% of c-sections are elective. Based on personal experience with my social circle, I believe that number is actually on the low side.
This is a complex issue that includes the following considerations contributing to the high C section rates. There are cultural pressures to maintain pre vaginal birth vulva and perineum so many women of these cultures wish an elective c section. The age of women having their first child has risen and along with it maternal /fetal risks for complications such as hypertension, increased fetal birth weights due to diabetes , maternal obesity, increased multiple births, increased infertility, resulting in reproductive interventions such as IVF. The choice of the women to have elective c sections due to fear, anxiety about the pain of a vaginal delivery. One may say all the above is the medicalization of what should be a natural process but much of it is driven by patient choice and increased maternal health risks. There is a reason women who have access to first world labour and delivery units have such a low maternal/ infant mortality rate.
Two more reasons. In the U.S., at least, providers are paid far more for a Caesarean than for a natural birth. Also, natural births used to be abetted by midwives or nurses, primarily females. Doctors, primarily males, perform Caesareans, thus appropriating what used to be a female function. Same old story.
Just for the record, over 60% of ob/gyns in the US are female.
Oh yes----always the expensive option..and so many "tests" etc. to try to avoid law suits. The whole medical system has become an expensive mess.
Sheila Kitzinger's book "Rediscovering Birth" is very good. It compares medicalised and traditional birth patterns. The photos of a hospital where all caregivers are looking at a machine compared to traditional midwifery where all the caregivers are looking at the mother, observing the mother, are very powerful to me. The highly medicalised birth where the power of what's happening is in the hands of those who can read the machines (generally not the mother), compared to the shared knowledge of the traditional setting. I am a mother of 8, and have doula-ed a few times. Women's birth stories are very powerful to them, and on their behalf I resent this being taken away from them by a culture of fear, both within the medical system and across our societies in general. Australia.
Hear hear!
I comment as a mother who had two successful VBACs, as a midwife and as a volunteer breastfeeding support worker for over 40 years. I have watched in horror as section rates have risen and VBAC rates have fallen due to the factors you have described here.
If I had to sum this up in one word, it would be "trust" because that is now absent in most Western maternity settings. It's not just an absence of institutional trust in birth; women are now socialized to not trust their own bodies or their own judgement. The "faulty female" reigns in most hospitals and due often to monetary constraints, women are not allowed to labor at their own pace, because everyone has their eyes on the clock.
Yes, women giving birth now are indeed older, fatter and generally unhealthier, but the same factors feed into this too. Women are told they must have everything in place before embarking on pregnancy: fulfilling careers (that they will need to return to), a house and every other thing they "need" before becoming mothers. So, by the time they feel ready to become pregnant they are in their late 30s or even in their early to mid 40s and it comes as a shock to discover that it may not "just happen" for them.
All the young women who are now freezing their eggs courtesy of their employers are in for the crushing disappointment that is inevitable for most of them when they realize that they will never be biological mothers because those fresh, young eggs aren't viable 15 to 20 years later. Funny how the fertility clinics charging yearly fees for egg storage didn't tell them this.
Nearly anything can be medicalized, but this is not always a universal good. Yes, I know that more women and babies died before some common practices started being utilized, but women and babies still die, and sometimes it's because of what we do, not what we don't do.
Let us be free!
I believe one of Sheila Kitzinger's books (can't remember off the top of my head) set out to show that the hospital model was safer than the homebirth option. In the end she concludes that they are equally "safe". I've doula-ed at VBACs of a friend's. The doctors worked towards theatre, the original midwife (for her first) had no idea how to care for her apart from watching the machine monitoring her. Thankfully the last midwife (the labouring went over at least two shifts) spoke up for my friend to be able to continue. The midwife had just returned from working with Aboriginal women in Northern Territory, Australia, and was obviously more observant and "connected". My friend went on to have two more VBACs each with less medical intervention, having restored her own sense of empowerment: that she could do it. That was years ago. This last year I attended the hospital birth of my daughter's second child, and I was appalled by "care" of the hospital team: time constraints, fear, so risk-conscious that it interfered with the bonding process, and more.
Over thirty years ago when my children were born, my wife read many caesareans were done in order to schedule a birth rather than having the uncertainty of labour. My question is why should child birth seemingly be hijacked by the medical profession. I agree there are at times the need for medical intervention. But I find it hard to believe over 30% of childbirths let alone the 50% in the UK need such intervention. Women are owed an explanation. Also is there an advantage for the child to undergo a natural birth?
Yes in every way it’s an advantage for a child to undergo a natural birth. One thing I know is the birth canal contains all sorts of healthy bugs which support the baby’s healthy growth and immune system in ways we just can’t know yet.
In the science lab of my own family, my c born twins struggled with low weight all their childhood but my natural born daughter flourished. Coincidence? Maybe. But I don’t think so.
It’s about trying to control the uncontrollable.
“Good maternity care should begin with confidence in the healthy female body, offering continuity, patience, and skilled support while remaining ready to intervene when genuine complications arise.”
I was lucky enough to give birth to my first child in the Netherlands, where I was repeatedly told this: "Your body was made to do this. You just need to let it do its job – and in the unlikely event that you need intervention, the very best will be available". I was "accompanied" during labour by calm and expert midwives, having had the best possible antenatal preparation. I had no pain relief – it was not given routinely in the Netherlands – but I was allowed to move freely. It was a thoroughly positive experience – no stitches, and a very speedy recovery. I was home hours later, with ongoing support for eight days.
Just letting your body do its job, though, is increasingly seen as undesirable. I have worked with many young women, on multiple medications, who appear determined to stop their bodies functioning naturally in any way at all. Part of this is undoubtedly about a need for control, and an unwillingness to suffer any kind of discomfort, which earlier generations accepted was neither possible nor desirable.
That's interesting. I'd like to see a sociological/psychological study on the history of this profession.
Low calibre midwives.
This article would have been credible if it provided statistics. Different historic periods, different areas of the world. C-sections save lives. Conspiracy theories and extreme deductions don't. Women are advised by doctors of risks in the West. They will always decide proactively for preserving the living . No expectant mother wakes up and thinks " you know? I'm gonna have me a C-section ".
Never heard of it. Is there proof that women make such decisions?
I agree with you regarding the importance of providing relevant facts and stats.
However, your comment “No expectant mother wakes up and thinks " you know? I'm gonna have me a C-section ".” is naive. According to the CDC approximately 10% of c-sections are elective. Based on personal experience with my social circle, I believe that number is actually on the low side.
This is a complex issue that includes the following considerations contributing to the high C section rates. There are cultural pressures to maintain pre vaginal birth vulva and perineum so many women of these cultures wish an elective c section. The age of women having their first child has risen and along with it maternal /fetal risks for complications such as hypertension, increased fetal birth weights due to diabetes , maternal obesity, increased multiple births, increased infertility, resulting in reproductive interventions such as IVF. The choice of the women to have elective c sections due to fear, anxiety about the pain of a vaginal delivery. One may say all the above is the medicalization of what should be a natural process but much of it is driven by patient choice and increased maternal health risks. There is a reason women who have access to first world labour and delivery units have such a low maternal/ infant mortality rate.