Reluctant doctors like to believe that they haven't much influence over their patients, but that is clearly not the case. Several studies have found that when doctors genuinely encouraged women to have VBACs, most of them did, and when they said nothing or acted neutral, most women didn't. Finally, when obstetricians discouraged VBAC in women who wanted to try it, none of them did.

A study of interactions between women and obstetricians offers an explanation. It described three levels of increasing power imbalance: In the first, you fight and lose; in the second you don't fight because you know you can't win. However, in the highest level of power differential, your preferences are so manipulated that you act against your own interests, but you are content. Elective [meaning requested for no medical reason, not to be confused with needed surgery planned in advance] repeat cesarean exemplifies that highest level.

Labor will hurt. Probably a lot. But whether this is negative is another matter... A laboring woman can be in a great deal of pain, yet feel loved and supported and exhilarated by the creative forces flowing through her body and her ability to meet labor's challenges.

You can't be said to make a choice when you only have one option.

Of course, if 40% of women need oxytocin to progress normally, then something is wrong with the definition of normal.

When intervening becomes routine, meaning there is no reason for it, only risks remain.

Reluctant doctors like to believe that they haven't much influence over their patients, but that is clearly not the case. Several studies have found that when doctors genuinely encouraged women to have VBACs, most of them did, and when they said nothing or acted neutral, most women didn't. Finally, when obstetricians discouraged VBAC in women who wanted to try it, none of them did.