It's not merely my opinion (or the opinion of some filmmaker or Ina May or anyone) that there are too many c-sections perfomed in the US, that is a fact. The WHO estimates that depending on the level of prenatal care and other factors, the correct number of c-sections in any given area should be somewhere between 5 and 15%. In this country, we teeter closer to 50%. That's not acceptable. The c-sections are not producing better outcomes, not contributing to maternal or fetal health. It's a very broken system that needs to be evaluated and fixed.
I am not saying this to start an argument, because I do agree that some doctors/patients jump to c-section too soon. And, I have seen pit used in cases where I don't think it was medically justifiable (ex. mom presents in labor and is admitted at 2cm, labor progresses fine for 2 hours, recheck shows mom at 5cm, OB pushes pit so that 'progress doesn't stall'. WTF?)
However, I did want to point out that the WHO is not the end all be all of medical standards, and we need to consider their mission when we discuss their stance on subjects. Let's use myself as an example. By WHO standards, as my BP is controlled, my PP has mostly resolved to a low-lying placenta, and all three surgeries on my ute have not entirely penetrated the outermost layer of muscle, I should be expected to do a trial by labor and see what happens. However, by US standards the risk of uterine rupture is entirely too high to force a trial by labor to satisfy WHO observers, upwards of 40% risk.
The risks associated with a uterine rupture are severe and include bleeding out and dying on the OR table. I am not even close to the only person in country who has faced or is facing this, and every single one of us increases the dichotomy between actual number and the WHO ideal. I am comfortable with the US having those crappy numbers if it means moms like me aren't pushed into a ridiculous risk in order to satisfy an international group's ideals.
I understand that people are going to come back with some variation on, 'Oh, but its ok for you!' or 'That's not part of the 50% I'm talking about', but please understand that I am EXACTLY the part of the 50% that the WHO is talking about.