In my country the C-sections rate is very high (not sure I can trust my memory on the exact number). We pretty much decided to have our child born in a neighbor country, just to reduce the related risks, even if that included a risk that any medical complication would make the costs skyrocket (because our health insurance system does not like this kind of healthcare shopping).
From what I was told, seems like the most important factor is that C-section is more convenient for the doctor. For example, doctors can choose exact timing, to avoid a situation when two babies decide to get naturally born at exactly the same moment. Or they can make more babies get born during the day, when there is more staff at the hospital, and less during the night. (There are also other ways to artificially influence the timing, and yes, those are used too.) Another factor is that in my country it is more-or-less mandatory for mother during the childbirth to lie on her back… which again is most convenient for the doctor, but also happens to increase some risks associated with childbirth (which can be then conveniently solved by the C-section). If I understand it correctly, the position on the back is more dangerous because the child needs to be pushed uphill (over the tail bone).
What is even worse, when there are too many C-sections, a feedback loop appears—suddenly people (both the doctors and the patients) need to protect their egos by rationalizing that, actually, C-section is the best way to go. Which in turn further increases the rate of the C-sections, because if “everyone is doing that” then it is “perfectly normal” and certainly “happens for a good reason”, and people who think otherwise must obviously be wrong. So now you have mothers expecting to be given C-section, because that’s how it is usually done. And you have doctors giving C-sections at a smallest opportunity, because that’s what most mothers want them to do.
And communicating this with doctors is almost impossible. When you mention that, they will start lecturing you that sometimes the C-section is necessary to save the baby’s or mother’s life or health. And when you say “okay, of course in such case I would want you to do it, but if there is no complication, then I don’t want you to do that needlessly… I am even willing to pay to extra to compensate for all related inconvenience”, then the doctor usually gets offended or treats you like an idiot and says that “of course we are doing that only when it is necessary”. Except, comparing statistics across countries shows that somehow, in neighbor countries it is “necessary” in maybe 15% of cases, but in our country it is close to 50%… but of course, for each specific case the doctor can argue that this specific case happened to be an exception where the C-section was necessary. And no, they are not going to allow the mother to give birth in a different position, because that is simply not how things are done, full stop. (Cross the border to the nearest country though, and the local doctors are like “yeah, sure, no problem”.)
Generally, comparing medicine across countries can make you mad. Seems like in each country, doctors have a consensus on how things are supposed to be done, and they always claim that their opinions are backed by science. Yet somehow the “science” says sometimes completely opposite things in different countries. (I suspect “science” is a shorthand here for “what they taught me at university, a few decades ago”.) And if you look into peer-reviewed journals to find what the science actually says, you will usually get yet another opinion. (Though we noticed the trend that the peer-reviewed journals usually agree more with the “science” of our neighbor country than with the “science” of my country.)
In my country the C-sections rate is very high (not sure I can trust my memory on the exact number). We pretty much decided to have our child born in a neighbor country, just to reduce the related risks, even if that included a risk that any medical complication would make the costs skyrocket (because our health insurance system does not like this kind of healthcare shopping).
From what I was told, seems like the most important factor is that C-section is more convenient for the doctor. For example, doctors can choose exact timing, to avoid a situation when two babies decide to get naturally born at exactly the same moment. Or they can make more babies get born during the day, when there is more staff at the hospital, and less during the night. (There are also other ways to artificially influence the timing, and yes, those are used too.) Another factor is that in my country it is more-or-less mandatory for mother during the childbirth to lie on her back… which again is most convenient for the doctor, but also happens to increase some risks associated with childbirth (which can be then conveniently solved by the C-section). If I understand it correctly, the position on the back is more dangerous because the child needs to be pushed uphill (over the tail bone).
What is even worse, when there are too many C-sections, a feedback loop appears—suddenly people (both the doctors and the patients) need to protect their egos by rationalizing that, actually, C-section is the best way to go. Which in turn further increases the rate of the C-sections, because if “everyone is doing that” then it is “perfectly normal” and certainly “happens for a good reason”, and people who think otherwise must obviously be wrong. So now you have mothers expecting to be given C-section, because that’s how it is usually done. And you have doctors giving C-sections at a smallest opportunity, because that’s what most mothers want them to do.
And communicating this with doctors is almost impossible. When you mention that, they will start lecturing you that sometimes the C-section is necessary to save the baby’s or mother’s life or health. And when you say “okay, of course in such case I would want you to do it, but if there is no complication, then I don’t want you to do that needlessly… I am even willing to pay to extra to compensate for all related inconvenience”, then the doctor usually gets offended or treats you like an idiot and says that “of course we are doing that only when it is necessary”. Except, comparing statistics across countries shows that somehow, in neighbor countries it is “necessary” in maybe 15% of cases, but in our country it is close to 50%… but of course, for each specific case the doctor can argue that this specific case happened to be an exception where the C-section was necessary. And no, they are not going to allow the mother to give birth in a different position, because that is simply not how things are done, full stop. (Cross the border to the nearest country though, and the local doctors are like “yeah, sure, no problem”.)
Generally, comparing medicine across countries can make you mad. Seems like in each country, doctors have a consensus on how things are supposed to be done, and they always claim that their opinions are backed by science. Yet somehow the “science” says sometimes completely opposite things in different countries. (I suspect “science” is a shorthand here for “what they taught me at university, a few decades ago”.) And if you look into peer-reviewed journals to find what the science actually says, you will usually get yet another opinion. (Though we noticed the trend that the peer-reviewed journals usually agree more with the “science” of our neighbor country than with the “science” of my country.)