I am not an expert but I have heard that in some countries doctors are doing c-sections even in cases where it is not medically necessary, simply because it is more convenient for the doctor (can choose the time of the day, does not have to wait). So you get places where c-sections are about 15% of births, and you get places where they are about 70% of births; at both places the doctors swear that they are only doing it in the medically necessary cases, but it sound unlikely that humans on different sides of the border could be so anatomically different for this to make medical sense.
Also, c-sections allegedly make the following childbirth more difficult and dangerous. Again, I am not an expert, but I have heard that once you had a c-section, the following childbirths very likely need to be c-sections too; and that after you had two or three c-sections, another childbirth is life-threatening. So in the places where 70% of childbirths get c-sections, women can’t have more than 2 or 3 children.
I repeat, I am not an expert, this is just a few things that I have heard.
So… my best guess is that this was a game of telephone, where the message at the beginning was something like “unnecessary c-sections reduce population growth”, and someone misunderstood it to mean that all c-sections are medically unnecessary, so they banned them all. I admit this sounds stupid, but the actual outcome is stupid, so there had to be some stupid move along the way.
VBAC: The other common cause of a scheduled C-section is if you’ve had one before. Women who have given birth once by C-section are very often advised to have future babies the same way. Having a vaginal birth after a C-section is possible (it’s often called a VBAC, for vaginal birth after Cesarean) but not usually the default. Is this right? It’s actually a bit hard to know. There are no randomized studies.6 The best we can do is to compare women who had a C-section and planned a vaginal birth to women who had a C-section and planned a repeat C-section. This isn’t perfect—the kind of women who want a VBAC may be different from those who are happy to have another C-section—but done right it can be pretty convincing. And studies like this suggest that there are some increased risks to a VBAC. In one case, researchers studying women in Australia found that women who planned a VBAC had more serious infant complications and a greater likelihood of maternal hemorrhage. Both of these outcomes happened for about 2.5 percent of the women in the VBAC group versus only about 0.8 percent of the planned C-section group.7 The women in the two groups looked very similar in many ways—age, race, etc.—so we can have some confidence that the choice of delivery mode was responsible for the differences. And this is pretty consistent with other, similar studies.8 Without randomized evidence it’s hard to be rock solid on this, and, unlike in the breech case, many doctors will be fine with this type of delivery. Because of the possibility of increased risks, though, you do probably want a doctor who has experience with this situation so that she’ll know what to do if things start to go awry. If you do decide to attempt a vaginal birth, be prepared: about half of attempted VBACs end in a C-section.
The references are: 6. J. M. Dodd et al., “Planned Elective Repeat Caesarean Section Versus Planned Vaginal Birth for Women with a Previous Caesarean Birth,” Cochrane Database of Systematic Reviews 4, article no. CD 004224 (2004). 7 . Caroline Crowther et al., “Planned Vaginal Birth or Elective Repeat Caesarean: Patient Preference Restricted Cohort with Nested Randomised Trial,” PLOS Medicine 9, no. 3 (2012): e1001192. 8 . E. Mozurkewich and E. Hutton, “Elective Repeat Caesarean Delivery Versus Trial of Labor: A Meta-Analysis of the Literature from 1989 to 1999,” American Journal of Obstetrics and Gynecology 183 (2000): 1187–97.
Which adds the “fun” consequence that any poor woman who has already had a C-section in Turkey now is condemned to either never have any more children or risk a significant chance of death. Fantastic move.
I think it’s probably just standard naturalistic fallacy. Like, wanting a c-section to avoid the pain of giving birth is shirking away from the natural suffering that you’re supposed to stoically endure or something? Might even have a biblical element to it (not sure how much weight do Muslims tend to lend to Genesis 3:16, “in sorrow thou shalt bring forth children”, but it’s part of their holy texts). A lot of people going with these sort of vibes misunderstand “being able to face and suffer unavoidable pain is useful” for “actively suffering avoidable pain makes you stronger and more of a real person” or some such.
It sounds so weird I must be missing something. Any idea from someone what is the chain of thought behind it?
I am not an expert but I have heard that in some countries doctors are doing c-sections even in cases where it is not medically necessary, simply because it is more convenient for the doctor (can choose the time of the day, does not have to wait). So you get places where c-sections are about 15% of births, and you get places where they are about 70% of births; at both places the doctors swear that they are only doing it in the medically necessary cases, but it sound unlikely that humans on different sides of the border could be so anatomically different for this to make medical sense.
Also, c-sections allegedly make the following childbirth more difficult and dangerous. Again, I am not an expert, but I have heard that once you had a c-section, the following childbirths very likely need to be c-sections too; and that after you had two or three c-sections, another childbirth is life-threatening. So in the places where 70% of childbirths get c-sections, women can’t have more than 2 or 3 children.
I repeat, I am not an expert, this is just a few things that I have heard.
So… my best guess is that this was a game of telephone, where the message at the beginning was something like “unnecessary c-sections reduce population growth”, and someone misunderstood it to mean that all c-sections are medically unnecessary, so they banned them all. I admit this sounds stupid, but the actual outcome is stupid, so there had to be some stupid move along the way.
From Emily Oster’s Expecting Better [Chapter 18]:
The references are:
6. J. M. Dodd et al., “Planned Elective Repeat Caesarean Section Versus
Planned Vaginal Birth for Women with a Previous Caesarean Birth,” Cochrane
Database of Systematic Reviews 4, article no. CD 004224 (2004).
7
. Caroline Crowther et al., “Planned Vaginal Birth or Elective Repeat
Caesarean: Patient Preference Restricted Cohort with Nested Randomised Trial,”
PLOS Medicine 9, no. 3 (2012): e1001192.
8
. E. Mozurkewich and E. Hutton, “Elective Repeat Caesarean Delivery Versus
Trial of Labor: A Meta-Analysis of the Literature from 1989 to 1999,”
American Journal of Obstetrics and Gynecology 183 (2000): 1187–97.
Which adds the “fun” consequence that any poor woman who has already had a C-section in Turkey now is condemned to either never have any more children or risk a significant chance of death. Fantastic move.
I think it’s probably just standard naturalistic fallacy. Like, wanting a c-section to avoid the pain of giving birth is shirking away from the natural suffering that you’re supposed to stoically endure or something? Might even have a biblical element to it (not sure how much weight do Muslims tend to lend to Genesis 3:16, “in sorrow thou shalt bring forth children”, but it’s part of their holy texts). A lot of people going with these sort of vibes misunderstand “being able to face and suffer unavoidable pain is useful” for “actively suffering avoidable pain makes you stronger and more of a real person” or some such.
TL;DR: memetic brainworms.