Problematizing Choice in the Elective Cesarean Debate
A consideration of Henci Goer’s research around the issue of elective cesarean surgery in the United States reinforces the contention that the popular representation of elective cesarean surgery as a choice over which women are demanding more control is in fact both misguided and misinformed. Goer suggests that the research that is cited to buttress the claim that women prefer cesarean surgery over vaginal birth “supports nothing of the kind,” cites ten different studies that have been conducted to ascertain women’s preferred mode of birth and concludes that rather than electing or requesting cesarean surgery, the vast majority of women “merely agreed with the decision…or wanted [a cesarean section] in belief that it would be safer for themselves or their infants” (Goer 2001, 34).
What comes out is the recognition that the representation of elective cesarean surgery as a safe and equal alternative to vaginal birth that women are demanding the right to choose is supported by existing ideologies and power systems rather than based on any clear picture of scientific evidence!!! However, because perceived science is the dominant and authoritative voice that surrounds birth within a Western medical model of care, this representation is accepted as true and serves to further a picture of cesarean birth as normal and safe, despite the fact that, upon investigation, these claims appear to “contravene everything known about the comparative risks” (Goer 2001, 34).
The result of placing the debate about elective cesarean surgery within the context of a rights-based discourse is that cultural ideologies about equality and autonomy are employed without any consideration for the broader economic, social and bureaucratic factors that surround and contribute to the lived experiences of women. And while we must admit, it is possible to imagine a situation in which a woman, in conjunction with her doctor’s advice and information, pursues and receives cesarean surgery, may be and many times are happy with her decision and pleased with the outcome of a live and healthy baby. However, the contention here is that, while this scenario is imaginable, it is a far cry from the “groundswell of consumer demand” (Goer 2001, 35) that the Western media representation of the debate would have us believe exists. The hegemony of a biomedical perspective relies, in part, on the public perception of its knowledge as right, true and the best information on which to make decisions and take actions.
Resource:
Goer, Henci. (2001) The Case Against Elective Cesarean Sections. Journal of Perinatal & Neonatal Nursing 15(3): 23–38.
