[mahogany]

What leads to many Caesareans is the "cascade of interventions" which might include unnecessary induced labor (e.g. if a mother is not dilating "quickly enough"), an early epidural, or continuous EFM. Many of these interventions, including the ones I listed, increase the likelihood of having a Caesarean.

In such a highly emotional situation, many mothers will feel pressured to do what their medical provider recommends. So, yes, it's technically true that it's the mother's decision, but many mothers don't realize they have the right to refuse these interventions, or are too scared to advocate for themselves in these situations, or are not fully aware of the risks -- both to the mother and the baby. In that sense, the decision is largely made by the medical provider, and this decision is often made because of an unnecessary urgency to get the birth done (or other reasons, such as a lack of experience with vaginal births or a fear of being sued, but in any case these reasons are not primarily the mother's). That is the part I was referring to as unethical.

To be clear, if it is medically necessary, a Caesarean should absolutely be done.

[locutous]

Personal experience with the mother telling the nurse emphatically not to use an intervention, to have it ignored and done anyway at the behest of a doctor that isn't even on site. It was convenient for the doctor and had nothing to do with the health of the mother.

Also a personal experience of a nurse yelling at the mother to stop pushing when the baby is already partially out because the doctor is not there yet. Some babies just don't care to wait for the doctor if he is late.

Unfortunately, in my personal experience, the mothers desires are not generally held in high regard inside of a hospital.