This seems like a bunch of hype about not much. I scheduled a C-section for my second child, born a few months ago. My first child was delivered by emergency C-section four years ago, so I wasn't hassled about my decision; in fact, my doctor initially suggested it would be a safer bet.

I got a few raised eyebrows from the natural-birth mom brigade -- among them my good friend who'd had a VBAC for her second delivery and thought I should, too. But guess what? It's a personal decision. I did a risk analysis, and decided to make it a planned event instead of going through labor again and then possibly having to have a C-section anyway. I knew what I was in for on the recovery; we could arrange for our daughter to stay with friends (no family nearby to help out for four days) instead of waiting for labor to occur and being stuck with no help. The four days in the hospital were a welcome break, although I was glad to go home.

The health risks of either vaginal or cesarean delivery are very small; women should be allowed to make their own informed decision and tell everyone else to butt out.

-- Mary Owens

One issue that this article failed to address is cost. An elective, uncomplicated C-section costs significantly more than a spontaneous, uncomplicated vaginal birth. For women with insurance, this isn't an issue, but perhaps it should be. Dr. Bost argued that women are allowed to have various forms of plastic surgery, which are riskier than elective C-section, but failed to note that these women are paying their own way if they choose these surgeries. I have no problem with my health insurance premiums reflecting the higher cost of C-sections when they are medically necessary; I do have a problem paying for what amounts to elective surgery for women who simply don't want to sit around "moaning, panting, sweating, and screaming" as the rest of us do.

-- Joy Woller

The biggest problem I have with the recent articles and news mag shows about elective cesareans is the simple fact that the average person with insurance through an employer will not be able to get full (or any!) coverage for a C-section that is elective, because it is not medically necessary. Most insurance companies will pay for the surgery if there is documentation that a vaginal delivery won't happen, will harm mom or baby, i.e., making the surgery medically necessary.

The people most often quoted (celebrities, etc.) can afford to pay these charges without the need for insurance! This is an extremely dangerous picture to paint for the average woman in America, who cannot make this financial choice.

-- Lena

Oh my God, having babies is so hard and dirty! It sounds like a bunch of teenagers complaining here. I mean, how dare the medical community expect you to give birth the way in which nature intended?

If these women knew that childbirth was the least of it then they might reconsider the whole thing. Child rearing is not for the selfish or the faint of heart. If you can't even deal with the delivery, then God help you with the rest!

-- Kirsten Eyles

Dana Hudepohl's piece on elective C-section is full of sadness. We associate feminism with the "pro-choice" movement. However, if choosing to have an elective C-section is a feminist's cause du jour, then I guess I am no longer a feminist. Choosing an abortion or liposuction necessitates choosing a medical procedure because it is a means to an end -- an end that would otherwise be unachievable. Choosing elective C-section is quite different, simply because the female body was designed to give birth, a fact that a large number of women and doctors have obviously forgotten.

The women interviewed in Hudepohl's article describe labor as an excruciating, barbaric act where they are not in control -- all characteristics of a "medicalized" birth. These women do not seem to realize that there are alternatives, and instead run blindly to medicine to "cure them of their pregnancy." It is unfortunate that many women still do not appreciate the power in their bodies and do not want to experience the natural miracle of bringing life into the world.

-- H. Straw

I think the writer missed one important driving factor for this trend: For which do physicians get reimbursed the most -- a vaginal delivery or a C-section? Of course, the C-section brings higher reimbursement. Same goes for the hospitals in which they practice -- the O.R. suite brings in more money than a simple labor and delivery room. Health economists kindly call these sort of thing "perverse incentives." It scares me to think about what's next.

-- Liz Madigan

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