i've found someone that agrees, an obstetrician btw, i know this is long, but he makes the points pretty clearly imo:
Elective Cesarean Section: An Acceptable Alternative to Vaginal Delivery?
Dr Peter Bernstein, MD, MPH;
Peter S. Bernstein, MD MPH, Associate Professor of Clinical Obstetrics & Gynecology and Women's Health, Dept of Obstetrics and Gynecology, Albert Einstein College of Medicine / Montefiore Medical Center, and Medical Director, Obstetrics & Gynecology , Comprehensive Family Care Center / Montefiore Medical Group, Bronx, New York
Excerpt --> One argument often cited in favor of elective cesarean delivery is prevention of pelvic floor damage, which can occur with vaginal delivery. Stress urinary incontinence, pelvic organ prolapse, and anal incontinence have been associated with vaginal delivery.
But these adverse side effects may be more the result of how current obstetrics manages the second stage of labor. Use of episiotomy and forceps has been demonstrated to be associated with anal incontinence in numerous studies.
Perhaps also vaginal delivery in the dorsal lithotomy position with encouragement from birth attendants to shorten the second stage with the Valsalva maneuver [prolonged breath-holding], as is commonly practiced in developed countries, contributes significantly to the problem.
Nonetheless, the prevention of pelvic floor injury by routine elective cesarean delivery is not an appropriate solution. Rather, more research into the management of the second stage of labor is clearly necessary. Moreover, cesarean delivery does not guarantee protection against pelvic floor dysfunction, given the reports of similar rates of urinary incontinence in nulliparous woman as in parous women [2]
A potentially more persuasive argument in favor of elective cesarean delivery is based on the potential for fetal risks before and during vaginal delivery, including intrapartum death, intrapartum acquired hypoxic ischemic encephalopathy, and stillbirth at term before the onset of labor. What is not clear, however, is how many cesareans would have to be performed to avert these disastrous event and what the cost would be in terms of maternal morbidity and mortality in order to prevent a single untoward fetal outcome.
To suggest that performing an elective cesarean delivery in a low-risk patient will avert intrapartum fetal injury is very misleading. These outcomes are rare, even in higher-risk women. Indeed, they are so rare in women without any identifiable risk factors that an absurd number of cesarean deliveries would need to be performed to avert even one of these poor outcomes. Thus, resorting to cesarean delivery would not be appropriate standard procedure.
Although cesarean delivery has clearly become safer over the past 50 years with advances in antibiotics, anesthesia and thromboprophylaxis, it is still not without risks. Woman undergoing cesarean delivery have greater blood loss and risk of damage to internal organs. The mortality risk of under going an elective cesarean delivery with no emergency present has recently been reported as almost 3 times the risk of vaginal delivery. [3] In addition, risks to the fetus associated with cesarean delivery range from lacerations [a cut in the baby's face or head when the surgeon makes the incision into the uterus] to respiratory distress syndrome and transient tachypnea of the newborn. Although these are typically manageable, their cost will be multiplied many times over if more elective cesareans are performed.
One of the most significant risks of cesarean delivery is the need for a subsequent cesarean delivery. ... A repeat cesarean delivery carries significantly more risk in terms of placenta previa, placenta accreta, uterine rupture, injury to internal organs during surgery excessive blood loss, need for hysterectomy and maternal death. These risks rise with each subsequent repeat cesarean delivery. Risk of [placenta] accreta and previa increases with each subsequent cesarean delivery, reaching a risk of > 60% in women with 4 or more cesarean deliveries. [4] In addition, the incidence of emergency peripartum hysterectomy for abnormal placentation seems to be rising as a result of the increase rates of cesarean delivery.
A move toward routine elective cesarean delivery may also have significant costs in terms of lost opportunities for bonding between mother and newborn. A woman who has had a cesarean may be less able to care for her child and may have a more difficult time breastfeeding ..... Although this impact may be small for the individual patient, again, its costs multiplied over a large population may be great, based on the accumulating evidence for the benefits of successful long-term breastfeeding.
Arguments made by proponents of elective cesarean that it should only be provided to women who intend to have only 1 or 2 children fall flat, given that the rates of unintended pregnancy in the US approach 50%. And what of the woman who changes her mind 10 years later and chooses to have another child after having had 2 prior cesareans?
There may be no legal liability to the physician who performed the patient's first cesarean section when the patient winds up with a hysterectomy or worse, but that does not clear that physician of responsibility for performing a surgical procedure of unclear benefit upon a patient's request.
Some argue that, from an ethical point of view, allowing a patient to choose to deliver by cesarean is not substantially different from allowing her to choose to undergo cosmetic surgery. But cesarean is very different. The benefits of elective cesarean relative to vaginal delivery are not established and the risks are substantial, especially given the potential for future repeat cesareans.
That women are seeking elective cesarean deliveries is probably more significant in that it indicates the failure of modern medicine and society at large in the sense that women may fear the experience of labor and birth attendants may fear the legal risks of allowing appropriate women to have a trial of labor. Modern management of labor should be reassessed to address the concerns raised by proponents of elective cesarean delivery. If elective cesarean becomes an acceptable alternative, we may never be able to undo the practice.