In May 2009, the British Journal of Obstetrics and Gynaecology editor-in-chief, Professor Philip Steer, is quoted in a wonderful article on the BBC News website, supporting a woman's decision to give birth surgically in preference to opting for a trial of labor. In it, he describes cesarean delivery as "a rational choice."
He doesn't say that all women would or should make this decision; rather, he defends their logic for doing so. Of course it is unfortunate that his views have not been taken on board by many of the NHS Trusts in England and Wales - quite the opposite according to the women who email me describing the difficulties they are having in trying to arrange a cesarean birth - but nevertheless, it takes a brave professional to speak out on this issue in the current political climate, and I for one, would like to applaud his efforts.
Below are just a few extracts from the BBC article, but you can read it in full here.
"Until as recently as the 1930s, maternal mortality around the globe was horrendous. In the early 1930s, one in 250 women in UK who became pregnant would die as a result - the same as in India today... Advances in the technology of surgery, anaesthesia, blood transfusion and antibiotics have so dramatically improved outcomes in developed countries that mortality is now one in 10,000 or fewer...
"You would think that these technological advances would be greeted with universal acclaim, but many women see childbirth as an essential "rite of passage" and exhort others of their gender to eschew technological assistance (is this "the female macho"?)...
"In BJOG (an international journal of obstetrics and gynaecology), the majority of valid science we publish goes unnoticed by the mass media. But publish something about home-birth, and we are guaranteed to get onto the national news. The discussions that ensue are repetitive, predictable and fail to distinguish emotional wish-lists from practical reality.
"Delivery by Caesarean section now accounts for almost a third of all births in many developed countries, and is remarkably safe - certainly as safe as many of the cosmetic operations that do not excite similar criticism. And yet many still argue against allowing women the autonomy to choose their mode of birth, either on spurious economic grounds or by suggesting that "birth is natural so we mustn't become dependent on technology". Without the technology of agriculture, transport, housing and energy generation, how many of the world's population would survive?"