I had Group B strep with my first child, and so my doctor AND I decided to iduce my labor. That way i could get the anti-biotics in my system that would help protect him before delivery, and my delivery would be closely monitored from start to finish. I had no desire to be cut open, so i choose to deliver vaginally, rather than have an elected CS. I did have an epidural, only after I decided i was ready for one. Unfortunately my epidural was not effective and so I ended up delivering without the help of pain relief. All in all it was okay.

I am 9 months pregnant with my second child now, and unforturnately I have been diagnosed with gestational diabetes. I have talked to my doctor about every option open to me. Obviously with concerns about a baby that is very large due to the diabetes, I was given the option of an elected CS. I have decided I would prefer a vaginal delivery again. Not because I’m scared of risks to myself or my child. I am well informed about the risks, but because i dont like pain medication, it makes me feel unnormal, and out of control.(I had a bad experience with pain meds after a minor surgery, but thats another story!) My doctor will be inducing me, my choice, and we will go from there. Whether i decide on some sort of pain management or not;having a baby, no matter HOW they come into this world is natural enough.

Richard Posner, Sex and Reason

These may in fact involve markets, or at least market-like mechanisms, to a very appreciable extent. In the case of sexuality and family life, whether it’s prostitutes in search of a quick customer or a chaste virgin looking for lifelong support of her motherhood, the women are ‘advertising’ and the men are definitely paying. As for spirituality, the advertisement, sales, and PR techniques employed by churches are even more literally similar to those deployed for normal worldly products—and once again, the payments are definitely literal.

You may object that the facets of life you mention here are more emotional and instinctive, but I think you have overstated the rationality and information basis behind much of consumer choice.

BTW, your emphasis in an earlier comment on replication as essential to science provoked a post that would have been even more of a threadjack than this comment.

and then writes,

“The point, made again and again, is that there is no right or wrong choice, so long as individual preference is served. ”

Ah-ha. I think this is why you don’t yet get my point. There _IS_ a right and wrong choice–but that choice isn’t going to be the same for any two women. For example, if you are 38 weeks pregnant, your midwife estimates that your baby is over nine pounds at this point, pain avoidance is a high priority for you, you don’t want to be induced, and other considerations aren’t as important, then having an unmedicated birth is the WRONG choice for you. Similarly, if you have an ideological commitment to natural family living, are expecting a smallish baby, have a high pain threshhold, and have had a previous successful unmedicated birth, than an elective c/s is the WRONG choice for you.

The part about not judging others comes from two things:

(1) we almost never know enough details about the circumstances of another’s situation to be able to tell her in casual conversation on the playground, “Oh, in that case you should definitely _________.”

(2) I reject the notion supported by (most of the) natural birth advocates that there is one best way for all women.

Did that help, RW?

LisaB, I’m a little chagrined (mostly at myself) that we’ve made it 154 comments and only now are explicitly introducing the idea of seeking inspiration for these decisions. Thanks for bringing that up.

For what it’s worth, I think you’re overreading my critique of the language of consumer choice. Frankly, I’d far prefer to see childbirth ensconced in a market than in a metaphysics: markets, as you point out, are at least rational and efficient. I don’t dispute the point that a genuine market mechanism can promote cooperation and distribute power, and all the rest; nor do I dispute (indeed I explicitly acknowledged in my first comment) that the language of choice and preference originating in consumer choice, thin as it is, serves a useful political purpose for the embattled. But at this point, at least, modes of childbirth do not, in fact, array themselves as shelved products or traded futures—we just talk about them as if they do: as Julie acknowledges, consumers of childbirth services are largely unaware of even the *relative* costs of the items for sale (nor, of course, are c-sections actually for sale yet). My massive empirical generalization was directed at the application of a particular subset of consumer discourse—the value-free language of preference and taste as a form of subjective self-expression (the Amazon.com wishlist version of selfhood, if you will)—to areas of human experience that are not (yet) facilitated by genuine markets: sexuality, family life, spirituality and the like.

Finally, it may be true that “there is nothing about the notion of choice or consent that requires that one be indifferent as to ends chosen.” But the presumption that structures at least the comments on this thread (I confess that if my last try was a no-go, I can’t wrap my head around what Julie herself is arguing) seems precisely to disclaim this: the “it’s my body, my preference, my choice, nobody else can judge me or even suggest that I should think about another option” line of thinking that has prevailed here assumes a thoroughly relativized—or at least radically individualized—array of ends. The point, made again and again, is that there is no right or wrong choice, so long as individual preference is served. This version of consumer preference, though it may share with the idea of moral choice a logically prior notion of agency, seems to me to share very little else.