Childbirth in a Technocratic Age: The Documentation of Women’s Ex ...

cesarean delivery uniformly referred to their delivery mode as planned cesarean or planned c-section. Furthermore, their reports evidenced mixed feelings on avoiding labor and vaginal birth, with four (25%) mothers expressing some ambivalence about their anticipated childbirth pathway. Two of those four equivocated on the decision, referring, for example, to difficulty deciding between planned cesarean or VBAC, or mentioning resentment over perceived pressure from medical professionals to decide. The other two mothers planning cesarean delivery said they definitely would have preferred vaginal birth but “could not” pursue this approach because of either a convincing medical recommendation or an institutional policy. The remaining mothers in this group expressed no particular enthusiasm or excitement about the upcoming birth process, but they did comment on the advantage of knowing what to expect by virtue of either a previous cesarean birth or what they presumed would be a straightforward surgical procedure.

Expected Obstetric Caregiver in Birth

With surgical training and practice primary features distinguishing physician from nonphysician obstetric caregivers, 15 of the 16 mothers anticipating cesarean delivery expected that an obstetrician would attend their births specifically to perform the surgery; one mother unfamiliar with obstetric training and practice was unsure whether a midwife or an obstetrician would perform surgery. Similarly, in the wake of professional recommendations for planned VBAC care (ACOG, 2010), all mothers planning VBAC expected to have an obstetrician attend their births.

Because mothers anticipating vaginal delivery are not planning surgery, nonphysician obstetric caregivers (certified midwives or nurse-midwives, in the present case) may theoretically attend non-VBAC vaginal births in or outside hospitals. Of the 59 mothers planning vaginal birth (including VBAC), 32 anticipated a physician-attended birth (30 obstetricians, 2 family practice physicians), and 22 anticipated either an available midwife or physician obstetric caregiver. All five