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Comment by Angostura | Hacker News Reader

> How a baby is delivered is none of anyone's business but the mother herself. I'm sorry for your loss.

Caesarian's costs the NHS around £1,700 a time compared with £750, for a normal childbirth and women also stay in hospital for twice as long on average. There is a general presumption in the UK that avoiding what is an invasive operation is preferable for both baby and mother alike, in the absence of other factors.

I would argue that clearly How a baby is delivered is other people's business since other people are involved. However the ultimate choice should be the mother's.

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Vaginal delivery is associated with better outcomes for the child too. IMO that makes it not strictly the mother's choice. Indeed surgical procedures should never be entirely elective.

No, you don't get to make major body and life decisions for a mom because maybe infant outcomes are 1% better in certain circumstances. Somehow I doubt you donate 90% of your income to children in need, which would actually drastically improve outcomes for 1000s of babies.

If I donated 90% of my income then my children would starve.

However, we do have a process whereby use of my wage income is not entirely elective, it's called taxation and in part is used to improve outcomes for other people's children.

In your opinion should infants have no advocacy, should mothers (parents presumably) have complete determinency over the medical needs of their children without regard for medical outcomes.

> Vaginal delivery is associated with better outcomes for the child too. IMO that makes it not strictly the mother's choice.

Strongly disagree. The mother's freedom is not subservient to the child's wellbeing. Stable families are also associated with better outcomes for children, does that mean a man should not be allowed to divorce his spouse after they have children? What about second hand smoke or the psychological effects of parents' alcoholism on a child? I could go on (consider Vaccinations), but if a child's outcomes are the primary concern why stop at C-sections?

> Indeed surgical procedures should never be entirely elective.

Why not? What about plastic surgery, liposuction, or gastric bypass? This is a weird sort of medical puritanism.

You’re kidding right? The fact that parents are legally required to care for their children for 18 years throws a wrench into the theory that the freedom of parents is paramount. I don’t think there’s any precedent in culture or our legal system that puts freedom of parents at a higher priority over well being of children - nor should it. Children have no choice whether they are brought into the world, potential parents have full volition. Thus morally it is perfectly fair that the party with zero choice - the children - are protected.

> The fact that parents are legally required to care for their children for 18 years throws a wrench into the theory that the freedom of parents is paramount.

Except they're not. It's called adoption.

> I don’t think there’s any precedent in culture or our legal system that puts freedom of parents at a higher priority over well being of children - nor should it.

I just listed several including divorce and the freedom to choose to vaccinate (or not). I never said that the freedom of the parents is paramount, but it's also not fully subservient to the child's wellbeing. It's a balance. And my larger point is that mandating that someone go through a painful and potentially physically scarring natural birth for a dubious improvement to the child's development does not make the grade by this standard.

Nobody gives a stuff about the cost, you'll get the same pressure if you plan to deliver privately.

There's fewer than 700,000 births a year. If every one was a c-section it would cost an extra £700m a year, less than 1% of the NHS budget.

NICE guidelines state that the woman should discuss the pros and cons and then it's her choice.

> then it's her choice

Well, yes, but that doesn't mean it's a choice between two roughly equivalent options. C-Sections are invasive surgeries and come with added risks. I would argue a healthcare provider's duty is to advocate against them unless there is an appropriate medical reason.

That would be the discussion of the pros and cons.

Exactly. I don't know what your experience has been but generally the pressure from medical professionals is because C-section risks outweigh the benefits most of the time.

> I would argue that clearly How a baby is delivered is other people's business since other people are involved.

This is one major reason to oppose publicly funded health care. _Every_ decision becomes a public one.

The situation isn't terribly different for private health insurance. You're still spending out of a shared pool of dollars, and you don't have complete freedom in how you choose to do so.

And I would never choose a health care system mostly funded out of private insurance either.

Much better for every decision to be a private one made by insurance executives on your behalf.

Even if that were true, which I don't think it is, it still seems very much preferable to not getting necessary treatment because it's too expensive.

£950 for something that occurs once per lifetime seems extremely negligible.

And probably can be divided by 2 or 3 (twins, triplets) more frequently than non-caesarean births can.

and that’s why we don’t want socialized healthcare in the US. because it shouldn’t be other people’s business

In the US, we still make it other people's business. It's just that here, those other people work for insurance companies whose goal is to turn a profit (even if they claim otherwise by getting themselves classified as non-profit organizations), in part by paying out as little as possible to healthcare providers. Yes, it's theoretically possible to pay out of pocket, so one has a "choice", but doing that for e.g. a C-section would bankrupt most of our population.

I've lived in a country with socialized medicine. It's not perfect, but at least they don't have a huge chunk of the population walking around with easily-treatable conditions that slowly destroy them because normal people don't get decent health coverage.

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