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Cesarean Wars

By Robin Elise Weiss, LCCE, About.com

What would influence a woman to choose surgery, knowing the potential risks to her and her baby? Is there something more behind the decisions of the women who make this decision?

Connie Banack, cesarean mother and president of the International Cesarean Awareness Network, has other ideas, "I become concerned when they are used selfishly or out of fear of the alternative which can happen to both caregiver and the mother/partner dyad. Cesareans are not a safe alternative to vaginal birth and elective cesareans, those done before the mother goes into labour, place greater risks on both mothers and babies."

Banack adds, "I am not against cesareans. When they are used to save the life of mother or baby, they are an important part of birth and cesareans can become a good birth experience with the support of caregivers and family members. I know because with my last cesarean I had a great birth experience in that I was well supported, my questions were well answered, my concerns were addressed and my decisions honoured."

Who should be given the opportunity to make a decision like this? It's well and good to say that all women should have the right to make the decision to have an elective cesarean without medical necessity, but will that apply to women who have no insurance? Will that effect insurance coverage for women who make this decision? If this is something that is a right, it should be for all women, not just the select few who can afford the difference in the cost of the birth, which can be upwards of $4,000 for the difference alone.

We often talk about the rights of the women, but rarely talk about the rights of the obstetrician. Should the obstetrician have the right to refuse to do an elective cesarean surgery when there is no medical reason for doing so? After all, not every physician believes that elective cesareans are appropriate. This is but one of the considerations that we should address when keeping our doctors in mind. What about potential lawsuits brought by consumers after an elective surgery where the mother is suing for a complication from the surgery she chose? Will this be allowable?

Jukelevics believes that this debate will have a major impact on maternity care in many ways not previously thought of, "I ask myself why are they not also giving women the right to choose not to have routine medical interventions? Episiotomies? The right to move around in labor? The right to midwifery care? The right to universal healthcare?"

There is no one answer to this question, particularly not it's implementation. The theoretical debate will continue. There will be women who are allowed to make this decision and there will be women who are denied the ability to make this decision, for financial or availability reasons. The important thing to remember is that we are all different and we do all have differing opinions and lives. What we bring to birth is not the same and how we give birth does effect how we parent, including the ability to make decisions for ourselves and our children.

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