title: Elective caesarean section as a transformative technological process: players, power and context.
abstract: OBJECTIVE
  In this paper we present a critical analysis of the debate surrounding elective caesarean section using the Social Construction of Technology perspective as a framework of analysis.
  
  
  BACKGROUND
  The rate of caesarean section births is increasing worldwide in industrialized countries. Reasons given for the increase include women's characteristics, care providers' attitudes, prevention of pelvic floor disorders and adverse outcomes.
  
  
  METHODS
  CINAHL, PubMed, Ovid, Academic Search Premier and Cochrane Data bases were searched for the years 2000 to 2007 using search terms elective caesarean section, caesarean section on demand and maternal choice caesarean section.
  
  
  CONCLUSIONS
  The social constructivist approach explains how caesarean section as a mode of delivery has been transformed from an emergency to an elective procedure. Analysing elective caesarean section as a socially constructed technological process exposes positions taken by obstetricians, midwives, perinatal nurses and women, including the power dynamics and contextual influences.
  
  
  CONCLUSIONS
  The Social Construction of Technology perspective creates space for perinatal nurses to examine the implications of the use and meaning of elective caesarean section in a broader social context. Examining elective caesarean section from the Social Construction of Technology perspective exposes an emphasis on safety and risk for the foetus, while avoiding the equally important goal of promoting optimal postnatal health for mothers and infants. The Social Construction of Technology perspective highlights how those who define the problem control the solution.
authors.affiliation: Perinatal Specialty Nursing, British Columbia Institute of Technology, Burnaby, Canada. nancy_hewer@bcit.ca
authors.forename: Nancy
authors.initials: N
authors.lastname: Hewer
authors.forename: Geertje
authors.initials: G
authors.lastname: Boschma
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Hall
mesh_terms: D001291:Attitude of Health Personnel; D002585:Cesarean Section / Q000451:nursing / Q000523:psychology* / Q000706:statistics & numerical data; D003657:Decision Making; D017558:Elective Surgical Procedures / Q000451:nursing / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology; D009742:Nursing Theory; D009773:Obstetric Nursing; D011247:Pregnancy