Women who choose cesarean absent a medical indication for cesarean in North America are often portrayed in a negative light. They are deemed a drain on the medical system (at least in Canada). They are called "too posh to push". They are called vain. There are those who would even deride them as being somehow unworthy of motherhood - after all, giving birth vaginally is the way "nature intended". Some people might even declare that women who gave birth surgically, have not "given birth" and are somehow "lesser women". Any woman who has had a cesarean or is planning a cesarean, feels compelled to defend her choice or the reason for it, as there seems no bigger travesty than an "Unnecesarean". Even Canadian policy makers feel as though a worthy goal is to "reduce the rate of cesarean births" and "increase the rate of attempted VBACs".
This situation generates many Unnecessary Things, far worse than surgery among a group of women who could have had a "normal birth" if only they let "nature take its course", but freely and with informed consent opted out of "normal birth".
This situation "unnecessarily" legitimizes the denial of patient autonomy - a woman denied a cesearean absent a medical indication for it has no recourse. She often does not even have the empathy of others - after all she has only been subjected to what is considered "normal".
This situation makes finding sympathetic care providers "unnecessarily" difficult for those who would prefer an elective cesarean birth. Many women are forced into a situation that lacks continuity of care, or may have to travel to access the care they need.
This situation "unnecessarily" generates feelings of inadequacy among those who through no fault of their own were unable to "achieve" a vaginal birth.
This situation "unnecessarily" increases the risk of truly traumatic outcomes for mothers and infants. Many mothers believe that if they just push a little longer, labour more, or refuse an epidural that they can avoid a cesarean birth. Many might delay to the point of an emergent situation which then risks being "unnecessarily" unconscious for the delivery of their child, "unnecessary" complications, "unnecessary" disability, and "unnecessary" death.
Other "unnecessary" things that result from this situation are "unnecessary" pain, "unnecessary" vaginal tearing, "unnecessary" sexual dysfunction, "unnecessary" post-natal mental health problems, "unnecessary" reconstructive surgery, "unnecessary" incontinance, "unnecessary" bias in the information given to women planning on giving birth and "unnecessary" guilt.
In sum, the situation as it is today, "unnecessarily" jeopardizes quality maternity care. It puts process ahead of outcomes, and that is what necessarily needs to change.