Caesarian birth: conflict in maternity services.

This study investigates the history of caesarean section and women's experience of the operation today.
There has been no systematic collection of historical data on caesarean section since 1944. This study now constitutes the most comprehensive compilation of the history of the operation to date. It illustrates the development of the medical ethos concerning women as patients and provides the background to the next phase of research: the experience of caesarean section.
Previous research on caesarean section has exhaustively analysed the indications for the operation, reasons for the increasing rate and women's perceptions of abdominal delivery. This study differs in
eliciting responses from women on a range of issues relating to caesarean birth in order to assess the quality of information given to women in hopital regarding the necessity for caesarean operations and
analyse the effects of abdominal birth on women.
Women's experiences were examined in a sample of 300 women who had delivered by caesarean section. Significant differences were found in reactions between women who had emergency operations and those whose caesareans were elective. The emergency caesarean women suffered more in all negative measures including increased feelings of pain and depression. Negative sequelae was found to relate to the unexpected nature of emergency operations and the use of general anaesthesia.
Subjectively women report that they do not suffer as a result of caesarean birth, yet objectively it is clear that they do. This anomaly is attributed to the unequal relationship between women and doctors. Women feel grateful for the treatment offered by the doctors and therefore do not express dissatisfaction with their care. Recommendations are made suggesting practical ways in which maternity services, in respect of caesarean birth, can be improved.

A thesis submitted in partial fulfilment of the requirements' of The Middlesex University for the degree of Doctor of Philosophy.