U.S. Rate of Cesarean Surgery: Medicalization of Childbirth as a Discursive Formation through the Frameworks of Intersectionality and Reproductive Justice

Abstract

Cesarean surgery (c-surgery) is the most common operating room procedure in the United States. The World Health Organization (WHO) suggests an ideal national c-surgery rate between 10 and 15% (WHO, 2015). In 2018, the United States experienced a c-surgery rate of 31.9%. Of the women who delivered via c-surgery, 21.7% were primary c-surgeries, or the percentage of c-surgeries conducted on pregnant women for the first time (CDC, 2019). Such findings indicate the overuse of c-surgery in the United States. C-surgery is a major abdominal operation that incurs serious risks for both mother and child. Three of the six leading causes of maternal mortality are associated with cesareans: hemorrhage, complications of anesthesia and infection. Furthermore, c-surgery may influence the well-being of subsequent pregnancies. Keag et al. (2018) found that women who had a c-surgery were 17% more likely to have a miscarriage and 27% more likely to experience a stillbirth in subsequent pregnancies. Thus, the overuse of c-surgery motivates analysis from feminist and medical communities as to the factors that contribute to a medically unnecessary c-surgery. The purpose of this paper is to assess the United States rate of c-surgery through the frameworks of Reproductive Justice and Intersectionality. This paper argues that the overuse of c-surgery is influenced in part by Evidence-Based Medicine and defensive medicine. In the evaluation of Evidence-Based Medicine and defensive medicine as factors that contribute to the overuse of c-surgery, the medicalized model of childbirth is understood through Foucault’s notion of a discourse.