I suppose we have to address Christina Aguilera

This week, Christina Aguilera told Hello! magazine that she scheduled an elective Cesarean section out of fear of vaginal birth because she'd "heard horror stories about tearing."

Rather than addressing what I consider an impertinent debate that rages on about the validity of a women's "choice" to have an elective Cesarean, I'd like to talk about what's really important here.

Such discussions are inappropriate and useless until we start talking about the fact that little girls in this country are growing up in a culture so rife with fear of normal birth that women are choosing abdominal surgery with all of its attendant risks, a five fold increase in the risk of respiratory distress syndrome for their babies, and a higher risk of placenta accreta in later pregnancies which can result in prematurity, severe hemorrhage and hysterectomy.

Until we are working to change this culture of fear, we are not giving women choices in childbirth. We cannot judge women like Christina Aguilera until we implicate society's contribution to driving choices such as these.

By the way...there are much less invasive ways of avoiding tearing during vaginal birth. Some of the main ones include: choosing a midwife for your care provider, avoiding epidural anesthesia so you have control over your pelvic floor, NOT giving birth on your back but choosing your own comfortable, upright position, and asking your midwife to provide hot compresses on the perineum as the baby is crowning. If you do tear even with these efforts, rest assured that most tears heal far more quickly than Cesarean incisions and become infected way less frequently. With appropriate suturing and care, tearing should not cause any long term issues, which is more than can be said for an elective Cesarean.