This article  discusses a particular case in which a woman carrying twins was advised to have a Caesarean birth but refused. One of the twins died during a natural birth and the woman was facing criminal charges. It isn’t clear what happened next. Maybe when I have more energy I will try to follow this up and find out what happened to her, and why. Anyway, some quotes from the article:

Since the advent of direct tests of fetal health in the 1960s, the process of birthing has become progressively more medicalized and the role of the obstetrician (typically male) has dramatically increased. The man in the white coat has been transformed into an expert needed by women who are made to feel incapable.

If that omnipotent obstetrician attended medical school in the 1970s, he may have used the textbook, Obstetrics and Gynecology, which includes this appraisal of the women they will be treating: “The traits that compose the core of the female personality are feminine narcissism, masochism, and passivity.”

If he got his degree anytime from the 80s on, his text could have been Medical, Surgical, and Gynecological Complications of Pregnancy, which warns future doctors how “dangerous” those patients “who consider themselves ‘socially aware'” are. That type of woman is “not necessarily more mature but are trying, by their active interest in everything ‘avant garde,’ socially as well as medically, to persuade themselves and other that they are…This is the patient who is interested in such methods as ‘natural childbirth,’ hypnosis, of using childbirth as an ‘experience’.”… the text concludes that such a woman “requires close and constant psychiatric support.”

… Obstetricians and hospitals are more highly reimbursed for surgical births than for vaginal births. “In the state of Washington… the Caesarean rate in nonprofit hospitals is 20%, while the rate in for-profit hospitals is 36%. A few years ago a Kansas health maintenance organization (HMO) changed its policies and began to reimburse doctors equally for Caesarean and normal deliveries, so there was no longer a financial incentive to do Caesareans. The Caesarean rate dropped from 28.7% to 13.5% in one year.”

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