I was asked if the impatience of doctors was why so many interventions occurred. I have my own thoughts and beliefs - I think many will echo others' experiences, but if you think of something I've forgotten, speak up!
I believe medical care happens the way it does for three key reasons:
The 4th would be arrogance.
Birth is slow. It can take hours and hours and hours. Doctors used to go to women's homes and sit with them throughout labor. They then figured out how to have nurses do their labor sitting for them and did that for awhile. Once they caught on that if they brought the women into the hospital they would be able to see a slew more women at the same time AND have nurses do the labor sitting, it was off and running. Time being of the essence, you know.
When families started coming into the birth room, nurses were freed to take care of more patients - thereby allowing more women to labor at the same time, too. Then medication - namely, an epidural - helped all of this tremendously. Give an epidural, slow the labor down, augment with pitocin and get the show on the road! tap tap tap on the watch face Oops, not going fast enough - time to cut. If I had a dime for every woman I have stood with who was given a time limit for labor or pushing and threatened with a cesarean - I would be able to buy a whole dress from Nordstom's.
Why are "urgent" inductions done during the week? Why are the majority of "emergency" cesareans done between 9-5? How can doctors, during the business day, disappear to "deliver" a baby, a placenta, and suture and return to the naked woman in room 3 in less than 20 minutes? Why do doctors insist on yanking placentas out when they know damn well it can cause a hemorrhage or prolapse? (because they can FIX it with surgery!)
Time is of the essence. The goal is as many women in and out in as short a time as possible so they can make more money.
More women = more money. The more expensive the procedure, the more money they make. The more procedures they do - interventions, medications, complications, supplantations they do, the more money everyone gets (hospitals and doctors). Because insurance is a game, billing exhorbitant amounts for every single thing (remember those $20 cotton balls?) gives the max amount possible - they say, to break even. I believe it is to break the bank.
Medicaid pays about $700 for an entire pregnancy, labor, delivery, and postpartum experience. If it is a cesarean, it pays about $1500. Many practices have a limit on the number of welfare clients they will accept. Insurance pays infinitely better, of course.
The more women they can see, the more procedures they can do, the faster they are in and out of the hospital - allowing the next round to begin. Oh, yes... more women = more money.
The courtroom has, for at least the last 20 years, (mis)guided "care" by scaring the wits out of doctors and nurses, forcing them into trying to control every second and every aspect of every delivery. Chaos is the enemy in the labor room - the winner in the courtroom. Doctors believe not monitoring is wreckless - there isn't a piece of paper to show the judge or lawyers. Intermittent monitoring? What if something happens between times on the monitors? Despite the dearth of studies showing that continuous monitoring doesn't improve outcomes, the law still believes it is one of the best keys to winning a case proving the doctor acted quickly when fetal issues arose. So what if the woman has to stay put in the bed. So what if she is made incredibly uncomfortable and has a baby stuck trying to rotate through the pelvis. Just break her water and attach a scalp electrode... "then you can move around as much as you want!" Sure. Now the baby is REALLY stuck, been poked in the head, and mom is screaming for an epidural because the pain is overwhelming.
Mission accomplished! We can now speed things up and get it all done faster.
'Round and 'round we go.
(I don't think I need to utter a word about arrogance, do I?)