Explaining the High Cesarean-Section Rate in Taiwan: Surveying Women Individualizing Risk, and Orientalizing Taiwan"

Abstract

This investigation analyzes the hidden assumption of current academic research and debates that explain the controversial high cesarean section rate in Taiwan. The major data for the analysis is 51 pieces of scientific research with empirical data. Over half of them focus on the backgrounds, behaviors and beliefs of birthing women, often assuming they could exercise individual choices between vaginal birth and cesarean delivery. Most of the research aims to find how women’s level of scientific literacy, irrational beliefs and maternal age contribute to Taiwan’s high CS rate. The routine of separating clinical factors and non-clinical factors in analysis, the academic division of labor that public health and social medicine should only study only only-clinical factors, and the assumption that only lay people have cultural belief but not the medical professional, lead to the dominance of women’s characteristics in explaining Taiwan’s high CS rate. Considering the low “maternal request” rate, i.e., less than 2% of all cesarean sections, birthing women’s behaviors and beliefs that lead to the high c-section rate in Taiwan is a distorted picture. The discourse of choice in such research does not mean to appreciate women’s agency but to blame them for their innocence and irrationality. I conceptualize this kind of research practice as “gendered and oriental Orientalism”, problematic in ideology and almost useless in solving the problem of high CS rate. I argue that only if we take the perspective of STS (science, technology and society studies), disclose the “inside” of obstetrics in Taiwan, rather than the “outside,” can we possibly fully explain the high cesarean rate in Taiwan.