In most of the literature on choosing an elective cesarean, the avoidance of labour pain is considered to be an inadequate reason to choose to have an elective cesarean section. It certainly wasn't THE reason I was lobbying for an elective cesarean during my last pregnancy - after all I had no idea what the pain of labour and delivery would be like. I had people assume that it was the reason for my choice, with my own step-mother-in-law greeting the news of our birth plan with "oh honey, just get the epidural". I'd typically responded with "my choice isn't just about the pain of childbirth.". In truth, the first time around, I anticipated that choosing cesarean wouldn't mean less pain overall, just different pain. I was anticipating trading the pain of labour and birth for the longer recovery and a longer duration of pain. I anticipated a qualitatively different kind of pain that on the whole would be roughly equivalent.
The thing is, I never imagined a circumstance in a major urban area in Canada where access to effective pain management (ie. an epidural) would be a problem. I had no reason to believe at that point in time that I would not have access to an epidural should I have decided to proceed with a vaginal birth.
Now, knowing what I know - I feel very differently about this. I think that the avoidance of being in a situation where the pain is not in control and is extreme, is a valid and reasonable reason to elect for a cesarean. It shouldn't be the only reason - but it certainly ranks a heck of lot higher this time around than it did the last time around. If the health system cannot guarantee access to effective pain management when it is known to be available, why should it expect women to just chance it with a natural delivery? If spontaneous labour comes with a risk of unmanaged and insufficiently mitigated pain that is off-the-scales, why should we expect women to willingly submit to that?
Why is pain in childbirth considered to be 'okay' - when pain in any other medical arena is seen to be something that should be managed and mitigated?
I believe part of the reason I found giving birth to my first child was traumatic (apart from a complete violation of my right to determine what happens to my body) - was the insufficiently mitigated pain I experienced during the process.
If access to effective pain relief (epidurals) during labour and delivery was guaranteed to occur on demand, then it likely isn't a valid reason to elect for a c-section. In the absence of that situation - I personally, think its very logical for a woman to choose a cesarean - particularly now that I know what I know about access to epidurals during labour in most of British Columbia.