The main focus of this new U.S. research was on which nonmedical factors might be addressed in order to reduce record-high rates of cesarean delivery.
As such, the research is presented in terms of which factors affected the risk of having a cesarean most (e.g. "higher educational attainment was associated with an increased risk").
But look again at the study of 1308 Californian mothers; it shows that a cesarean was more likely with women who:
*reported higher scores for "empowerment and self-care"
*reported high English proficiency
*were of greater maternal age
*had a higher educational attainment
In most other areas of healthcare, the type of woman described above has access to the best medical care, and is most satisfied with it - and yet because the subject is cesarean birth, this situation is being viewed as a problem that needs fixing.
Most likely, it will be your own personal perception of how birth 'should' be that will dictate your reaction to this post, but my own view is that we should be more concerned about the women who reported lower scores for empowerment and self-care in this study - perhaps they might have preferred a cesarean birth!?
Maybe not - but I bet they were never asked that question...