The Truth About America’s Most Common Surgery

In 1957, Ladies’ Home Journal printed a letter from a reader, identified solely as “Registered Nurse,” imploring the publication to “investigate the tortures that go on in modern delivery rooms.” She cited examples of the “sadism” she’d witnessed in an unnamed Chicago hospital: women restrained with cuffs and steel clamps; an obstetrician operating without anesthetic. Among some doctors, the nurse wrote, the prevailing attitude toward women in labor seemed to be “tie them down so they won’t give us any trouble.”

What stands out about the unidentified nurse’s observations, and the personal anecdotes other readers shared in response, “is how women were often treated as an afterthought, a mere container for their babies,” writes the journalist and professor Rachel Somerstein in her new book, . One of the clearest manifestations of this disregard for mothers, Somerstein argues, is the procedure’s ubiquity. The Cesarean delivery can save lives in labor emergencies, and it’s overwhelmingly safe—but in the United States, nearly one in every three births now results in a C-section, including for low-risk patients who don’t need them. For many of these women, the medically unnecessary operation presents a much greater to their life than vaginal birth, as traces what Somerstein calls the “cascade of consequences” following a woman’s first C-section, framing the procedure as a symbol of the daunting, interconnected phenomena that make American motherhood so dangerous. She posits that the U.S. health-care system has come to devalue the importance of human touch, relationship building, and interpersonal support, causing our medical infrastructure to fall short of other high-income nations in keeping birthing people safe.