If someone was to approach this and do some freedom of information requests on method of delivery and negligence pay outs, ELCS almost certainly would fare well. It would then generate statistics which would make for uncomfortable reading but probably wouldn't really help women.
ELCS are all done between 9-5 Mon to Fri. This is when the most experienced staff are available and when the most staff are on shift. Because these shifts are the sociable ones.
Time and again the underlying theme is lack of problems comes back to staffing, lack of leadership/supervision and lack of necessary skills out of hours in reports.
ELCS almost hide the problem because you wouldnt be able to tell if the outcomes were a result of the method of birth being a correlation or causation issue. Or most likely both. The potential for misreading and misusing this idea is huge.
When researching everything that I could possibly find about ELCS one thing came up that is really concerning. If you reach a certain percentage of ELCS then they become the cheapest method of delivery. Why? Because you don't have to fund out of hours care anywhere near as much. And this was what has happened in China. Women having very few children (one child policy until fairly recently) meant that risks associated with subsequent births were irrelevant (risk with vbs decline with second babies and subsequent babies). Only the risks for first births matters. And since much of the risk with an ELCS is for subsequent births, this mattered. It allowed China to have incredibly low staffing and of course this meant women had next to no choice because you would be foolish to risk a VB which tend to happen in the early hours of the morning when there's no staff around. It would have the effect in the long term of making this much more dangerous. But it's become so normalised that attitudes seem ELCSs as better.
There isn't a better method. Only a better method for each individual woman. This production line attitude to birth - which we've seen develop in the UK and in China in different ways isn't healthy.
It always comes back to the need for women centred care with the emphasis on the individual. You can't do this in an environment which has the priority of cutting corners and cutting costs. It has to be treated like a long term investment where if you put in money your outcomes across the board are going to improve.
As we can see from the figures in this in quite a startling manner that the lack of investment in women giving birth has done nothing but harm but no one has been monitoring this and there's been no accountability because these are 'separate budget pools' with no oversight and no one joining up the very obvious dots. That's 100% on hospital management who are easy breezy about spunking huge amounts on compensation because the easier management route is poor investment in services and then trying to cover arses rather than deal with known and obvious problems.
It's toxic.
The emphasis has been for women to comply with stupid notions about rates of C-section rather than hospital managers having to comply and account for high negligence claims and costs. Their solution has always been to throw it back onto women on the most dangerous day of their lives and to try and cover it up and do their fucking jobs properly.
Unfortunately I believe until we start seeing hospital managers legal liable nothing will change.