Don't tamper with Nature's schedule (National Post, March 03, 2004)

Blame it on Queen Victoria. When she availed herself of the new miracle of anesthesia for the delivery of one of her many children, the monarch conferred legitimacy on the hitherto frowned-upon notion of pain-free childbirth. Biblical literalists, mindful of God's edict on the expulsion from Eden -- eternal pain in childbirth for Eve and her descendants -- balked at women giving the technological finger, so to speak, to God and Mother Nature. Ordinary women had quite another take on the subject, though, and the blandishments of modern science soon prevailed over religious fundamentalism.

Since then, pain reduction techniques have varied, but nobody is any longer advocating submission to labour pain -- or any other kind -- as a duty or moral imperative. Up until recently, though, doctors have focused on pain-reducing strategies such as epidural injections to aid the natural process of vaginal delivery.

Now we're into a radical new phase. I first read about it last year as the "too posh to push" syndrome in England (named for Posh Spice, whose elective C-section was widely publicized). Middle-class British women were demanding and getting pre-emptive Caesarean operations, "even in cases with no evident risk of complication from natural childbirth."

And it appears this phenomenon has also crossed the Atlantic. The Canadian Medical Association Journal reported yesterday that Canadian women will soon be offered the choice of a C-section, even without supporting medical reasons. The American College of Obstetricians and Gynecologists agrees C-sections should be available "after adequate informed consent."

Today about 20% of births in Canada are delivered via C-section versus 15% in 1994, a quantum leap. The World Health Organization says any rate higher than 15% signals "inappropriate usage." Why the eagerness for surgery over Nature's plan? After all, surgery is invasive, increases the odds against a trouble-free second delivery, involves a higher risk of maternal mortality, and requires a longer recuperation period. The only thing in its favour: A woman knows exactly when her baby will be born.

The "advance" in this important goalpost of human control over childbirth, from the assisted natural process to the boldly interventionist, is symbolic of a change in attitude regarding the body's integrity. Our psychological relationship to both pain and pleasure has shifted enormously since the advent of pain-modifying delivery systems. Now that our old adversary, physical pain, has become largely manageable and managed, our expectation of increased psychological gratification has expanded. Where technology was once bidden to alleviate distress, it now seems mandated to confer happiness, or at least convenience.

But the increasing demand for C-sections isn't only about pain avoidance. There's no great mystery as to why many ambitious women are opting for planned deliveries. They have busy lives and careers that are tied to predictable schedules, not a good fit with the unpredictable nature of vaginal deliveries. In considering their own convenience first, modern women are looking at childbirth in the same light in which they have been trained to treat all other issues in their lives. What's best for me?

Feminist teaching puts the "needs" of women first -- certainly before those of men, cela va sans dire -- but also before their children. Choosing the time of birth herself instead of allowing the baby this first autonomous act: what an eloquent symbol of entrenched egoism in young women who have been marinating for years in the brine of feminist ideology.

It's interesting, really, the smooth co-operation that all these medical societies are so casually extending to these spoiled women. Usually when a medical procedure offers no particular benefit, doctors are at pains to discourage their patients from choosing it. England and Canada have public health systems. A C-section is more expensive than a natural delivery, involving more personnel and resources.

Necessary C-sections obviously must be made available to any woman who needs one. But why should taxpayers foot the bill for women whose chief concern is to avoid rescheduling hassles for meetings or vacations, when there is a perfectly viable and healthy alternative, involving a shorter hospital stay and the satisfaction of remaining conscious for the miracle of birth?

One wonders if there isn't a kind of political correctness at work here. Male doctors, who pontificated freely on women's issues in the old days, may now hesitate to disagree for fear of being branded as sexists. Women have made extraordinary gains in the medical world, and more power to them for achieving parity -- but that "more power" sometimes entails political solidarity on feminist agendas.

Once bottle feeding was seen as an improvement over breast milk. That's what convenience-minded women wanted to believe, but Nature's way was later proved to be more beneficial to babies. Women demanding C-sections will arm themselves with all kinds of justifications, but in the end, it's about a woman's sense of entitlement trumping her willingness to give top billing to baby over her oh-so-special Self.

© National Post 2004