That conversation should happen at the beginning of treatment. Which doesn't happen at a hospital.

This is taking about actual birthing.

There is little, if any, individualization at hospitals. It's a pretty horrible place to have a baby. Invasive care, constant interruptions, questioning decisions, sometimes IGNORING decisions entirely to do whatever the heck they want. Threatening to cease care if you don't comply, yep.

Honestly, I'm surprised the numbers are this low. Most people probably just comply with everything, that's the smoothest path through.