“A Woman’s Right to Choose”

2 October 2011 at 7:25 am Leave a comment

Recently on a forum I participate in, someone mentioned women who get pressured by their OBs into c-sections, and someone else spoke up in (what I interpreted as) a combination of defensiveness and genuine curiosity to ask why pro-midwifery folks always “get all preachy about” this issue, and why we couldn’t just see it as a woman exerting her right to choose a c-section.

I stopped to think about that. Personally, for me, I don’t mean to come across as “preachy” in the common, negative sense of the word, but I do often want to “preach” (as in publically teach, share, and proclaim) something I see as a little-recognized truth.

Here’s what I posted in response:

First of all, I’d just like to point out that research (the very very well-respected Listening to Mothers and Listening to Mothers II academic studies–huge, wide-ranging, very important, well done) has shown that women are not really “choosing c-sections.” It’s a myth. Women tend to be pushed by their care providers into it, but true “maternal choice cesarean” is very, very, very rare–basically non-existent. I can’t link to the academic articles, but here’s an abstract of a general-press version written by two public health experts in women’s and reproductive health on the subject.

So I can’t speak for anyone else, but the reason that I personally “get all preachy about” things like this is that I don’t really believe women are choosing, in free and fully-informed ways, to have major surgery that has significant risks for them, their babies, and their future births–I think a society that hides misinformation and non-evidence-based medical care behind the veneer of “a woman’s right to choose” is really doing women a disservice.

It was an interesting line of thought for me, because of course I do feel that as an argument it’s potentially worrisome in its longer-range implications. Like many women (and men, of course), I am firmly pro-choice in the sense of a woman’s right to freely and easily choose to have an abortion if that’s what’s right for her in a particular pregnancy at a particular point in her life. I do see how this “right to choose” argument can be turned on its head and used to advocate for “maternal-choice” c-sections, but I think that the balance of power–and the free flow of information–in these situations is so impossibly skewed that there really is no ability for a woman receiving standard, medically-minded prenatal care to “choose” a c-section.


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