The exploration of elective Caesarian sections as a choice around childbirth

Master Thesis


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University of Cape Town

A growing number of women in the private health sector are choosing to have elective caesareans in South Africa. This dissertation explores the motivations influencing women who choose an elective caesarean section (CS) for non-health reasons. Qualitative research describing factors influencing pregnant women’s decisions in South Africa is limited and inconclusive (Chadwick, 2007). Thus, most of the literature that was examined was internationally based .The literature review highlights how technology has given us more options and better care when it comes to pregnancy and childbirth. With the medicalisation of childbirth, however, obstetricians have more power and control in a woman’s life and therefore might directly influence the choices she makes. This study considered 10 South African women’s narratives of their decision-making process in deciding to have an elective CS. On average, it had been approximately 2 years from the time when the women had the elective caesarean section. As the aim of the study was to hear how the women positioned themselves in their stories, the researcher’s interventions were limited to a minimum through semi-structured interviews. The data was transcribed and the use of narrative analysis was employed to evaluate the data. This dissertation interrogated the word ‘elective’ in the context of a medicalised childbirth. The narrative structure highlighted how the obstetrician was a crucial decision maker for the women by either the language they used which conjured up images of fear or by simply portraying the elective CS as a rescuer for the pregnant women from her own ‘unruly’ body. All the women had chosen to place their trust in their obstetrician and the medical technology involved in childbirth. The choice of how they would deliver was handed over to the doctor from their first appointment. Elective CS are becoming an accepted cultural norm within the private health sector in South Africa. Women ultimately choosing CS see their bodies as a vessel for a healthy baby and that how the baby enters the world is less significant. Through the exploration, these 10 women’s doctors emphasized vaginal birth’s complications and underplayed its benefits. On the other hand, the best elements of CS are communicated and advocated and the worst underemphasised. Elective CS rate will continue to increase as long as women see it as their obstetrician’s choice in having a healthy baby.

Includes bibliographical references.