Why are more women requesting C-sections?

Does the scheduling convenience of C-sections outweigh the risks? Join Caroline and Cristen for a brief medical history of C-sections, as well as an exploration of doctors' concerns over the rising rates of the procedure.

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Episode Transcript

Speaker 1 (00:04):
Welcome to Stuff Mom Never Told You from how Stuff
Works dot com. Hello, and welcome to the podcast. I'm
Kristen and I'm Caroline and Caroline. A number of women
have written in asking for a podcast about cesarean sections. Well,

(00:25):
today's their lucky day, Kristen. Today is their lucky day,
because that's what we're gonna talk about, and specifically, we're
going to focus on the rising rate of C sections
and of elective c sections, of women telling their doctors, hey, doc,
I would like a C section to deliver this baby right,

(00:45):
as opposed to waiting for an emergency to happen, or
you know, or just allowing the doctor to decide saying, hey,
flip a coin. Heads is vaginal tails is through a
tum tum. That's exactly how it happened us. Actually, exactly
how it happens is. A csarian section is a surgical

(01:07):
procedure used to deliver a baby through an incision in
the mother's abdomen and a second incision in the uterus.
These incisions, both the one in the abdomen and the uterus,
are done horizontally. The one in the abdomen is done
typically near the pubic hairline. Whereas the one in the
uterus is done similarly uh in the lower part of

(01:28):
the uterus. Yeah, and that would be referred to as
a low transverse incision UM, as opposed to a classic
C section, which is something that really isn't used anymore,
and that was back in the day. Doctors would make
a large vertical incision that usually would prevent women from
future vaginal delivery due to UM heightened increase of uterine rupture.

(01:49):
But cesarean technology has improved UM and leading up to
the surgery, doctors might have you get blood tests in
case you need a transfusion. During the surge, they'll discuss
anesthesia options. Common choice, for instance, is a spinal block,
in which medication is injected directly into the sack surrounding

(02:10):
the spinal cord um. And then there's another choice called
an epidural, where the medication is injected just outside of
the sack. Either one sounds very painful, but probably not
as painful as actually shooting a baby at your vagina.
This is true right now. I I was delivered vaginally,
a personal time gather round. So I was delivered vaginally,

(02:32):
and my mother, I think, felt a single twinge of
pain and was like shot, please she had she had
the epidural. So anyway, if a health emergency prompts the
C section, rather than this is an elective C section happening,
the doctors will probably check the baby's lung maturity via amniocentesis,
because there is a concern that if the baby comes

(02:54):
out earlier than expected, that their lungs are not fully
developed and they could develop breathing problems at birth. And
in addition to that, cesareans don't take long at all,
usually less than an hour, but after the surgery, moms
will usually need to stay in the hospital for a
little bit longer than they would with a vaginal delivery,

(03:15):
usually for about three days, and it takes around four
to six weeks for the incisions to heal, during which
time no big surprise here. You can't have sex, And
I mean, I've heard the recovery is really painful. I mean,
the mom's out there correct me if I'm wrong, But
I don't think i'd want to be having any sex
or moving, walking, breathing, sneezing, taking care of a baby,

(03:37):
any of the thing. Now we're gonna get a little
bit into the history of the C section but first
let us clarify with the etymology of the cesarean that
it is not so named because it's derived from the
surgical birth of Julius Caesar. Yeah, the whole thing with

(03:58):
cesarian sections is that originally they were performed as a
last result. They were last resort. Sorry, they were not
to save the mother's life. It was typically performed on
dead or dying women to retrieve the baby, and so
Julius Caesar likely could not have been born through this
cesarean procedure because his mother is reputed to have lived

(04:20):
to hear of her son's invasion of Britain, so she
couldn't have had one more likely. Uh. The origins of
the term is the Roman law under Caesar decreed that
all dead or dying pregnant women must undergo the procedure
to save the child, and cesarian sections so that the
actual procedure of the child being delivered through the stomach

(04:40):
rather than through the vaginal canal has been around since
ancient times, long before Caesar even came around. It's even
in Greek mythology. There's a story about Apollo removing Asclepius
from his mother's abdomen and the Sky would go on
to found a religious medical cult, and imagining a Poul

(05:00):
being your doctor, I think I'd be cool with Apollo
delivering my baby sun God. Sure absolutely might need to
wear a little sunscreen. But there are also numerous references
to cesareans that appear in ancient Hindu text, Egyptian text,
of course, in Grecian text, Roman texts, and other I'm

(05:24):
just gonna keep saying texts over and over again, but
in all sorts of European folklore, and they're also ancient
Chinese etchings that depict the procedure. But then it's not
until fift that we have the first written record of
a mother and baby surviving the operation. But this is
a questionable story. Supposedly a Swiss sal Gilder, a far

(05:49):
cry from Apollo, performed the operation on his wife, but
again the origins of that are pretty murky um and
it was called though a cesarean operation shintil fifteen, when
Jacques Gilmo's book on midwhiffery introduced the term section sidebar,
I was laughed at by some nurses when I said midwifery.

(06:13):
They laughed laughed at me. It's midwiffery, So thank you
for pronouncing it correctly. So no nurses out there laugh?
Do you have like a do you regularly walked by
like a band of salty midwives on your way to
work at the bus stop. They're all hanging out smoking,
you know, jaws and dausin dice, you know those nurses.

(06:33):
So I mean speaking of midwhiffery. You know, that was typically,
as we've talked about the podcast before, that was a
women's centric thing. But cesarean sections were more male centric
as far as performing the operation. Women were barred from
performing it for for the most part until late nineteenth century.
But interestingly enough, the first recorded successful C section in

(06:57):
the British Empire was conducted by a wolf mean sometime
between eighteen fifteen and eighteen twenty one. James Miranda Stewart
Barry performed the surgery while masquerading as a man and
serving as a physician to the British Army in South Africa. Yeah,
the story of Dr Barry, just also on a side note,
is pretty fascinating because when she wanted to go to

(07:20):
med school, women were not allowed, and so she was like,
you know what, I'm just gonna start dressing like a
man and it totally worked. And it's funny because there
were writings at the time when Barry was in Africa
doing all this work from people who commented on how
uh this This doctor had a certain effeminiscy. He was

(07:41):
always trying to hide and he actually became embroiled in
this steamy love affair with a married aristocrat in Africa
as well, who gave Barry a dog named Psyche that
the doctor took around everywhere and Dr Barry for Canadian listeners.
Dr Berry was later transferred to Canada, thus becoming Canada's

(08:02):
first female doctor. H look at that British empire. Indeed. Indeed,
so we think of these successful c sections, the ones
where the mother and child actually do survive the operation,
as more of a modern procedure, but nineteenth century travelers
reported seeing it performed in Uganda and Rwanda, and the

(08:23):
wound would be sound shut and stuffed with like banana
leaves and things. I mean, it's it's very fascinating that
there were reports of you know, local village doctors performing
this without all of the quote unquote modern nineteenth century
British technology, right, but of course, as technologies such as
crucial elements like anesthesia become more readily available, and as

(08:46):
births start moving from homes into hospitals, new obstetrical and
surgical skills begin to be developed as well, and c
sections become a little safer and a little more common,
even though they're still considered for a very very very
long time to be last resorts. Yeah, and this is
around the time too, that doctors started advocating for that

(09:09):
low cervical C section, which reduced infection rates as opposed
to that uh more drastic vertical cut. Now, this is
a bit of a gory detail, but this technological development
of c sections is also a really good thing because
it replaced something called a craniotomy, in which if the

(09:29):
baby had to be delivered by emergency, since they didn't
know how to um surgically get inside of the womb
through a c section, they actually had to go into
the vaginal canal and and break the fetal skull and
pull the baby out that way. Yeah, so c sections

(09:51):
definitely a positive development, and its urbanization continues. One of
the other reasons why we see C section rates rises
not just because more women are trying to go to
the hospital to have their babies, but also because kids
are developing rickets, which is a nutritional deficiency that leads
to the softening of the bones, and all these women

(10:13):
were growing up with it and had malformed pelvis. Is
that prevented normal delivery? Now this was also addressed once
safe milk became more available. Um, but yeah, I had
no idea that rickets and c sections in the US
for somehow connected, no idea. And so you know, after
safe milk was available, kids are healthier, they have better nutrition.

(10:35):
But doctors were slow to respond to the reduced need
for c sections and kept doing them pretty much at
the same pace. And after World War Two, c section
rates never dropped back to where they were before rickets
became widespread, and today C section rates have reached an
all time high. And we'll get into reasons why that is.
But jumping forward to modern cesareans, let's talk about health

(10:59):
and say fifty and start off with risks to the baby,
because there are some risk associated, of course, with babies
delivered by c section. They are, for instance, more likely
to develop transient hipnia, which is a problem marked by
abnormally fast breathing during the first few days after birth.
And I have a feeling Carolina's related to that issue

(11:20):
of lung development that you mentioned earlier. C sections done
before thirty nine weeks or without proof of lung maturity
could also increase that risk of other breathing problems such
as respiratory distress syndrome. And there are some smaller risks
of surgical incidents, such as UH surgical nicks to the baby,

(11:40):
but that's very rare. Yeah. Um. There are more numerous
risks for the mother, although some of these are also rare. UH.
There's endometritis, which is the inflammation or infection of the
membrane lining the uterus that can cause fever, foul smelling,
vaginal discharge, and uterine pain. Increase risk during future pregnant
and see such as bleeding, problems with the placenta and

(12:02):
uterine rupture, and also increased bleeding more so than with
vaginal birth, reactions to anesthesia, blood clots, wound infection, injury
to other organs. So there are a couple that are
specific to C section in particular, but also just general
risks that you would face with most surgeries. Yeah, and um.
When it comes to emergency c sections, UH, complications that

(12:26):
tend to arise from those are on the upside, at
least more commonly linked to whatever medical condition prompted that
emergency delivery rather than the C sections. So while there
are definitely some more unique risks that are associated with
cesarean delivery, a lot of times those complications might be
more associated with a condition that a woman already came

(12:50):
to the hospital with. Now, one thing that moms and
doctors have been concerned with over the years is is
it okay uh to have vaginal childbirth after you have
had a C section? Are you only supposed to stick
with C sections once you've had one? And a two
thousand four study in the New England Journal of Medicine
said that serious complications are possible, but the absolute risk

(13:13):
is very small when you have a vaginal childbirth after
C section, which is abbreviated in these journals as v
B A C which I did not know it has
its own little abbreviation. So that said that the risk
being small, it is worth pointing out that when compared
to elective repeat C section, women attempting vaginal birth after

(13:34):
C section are at a somewhat increased risk of serious
obstectric complications, and that drives with a recent Australian study
that came out in which found that repeat C sections
might be a safer option. Um It found that among
babies born by a planned cesarean point nine percent and
died or had serious complications, compared with two point four

(13:56):
percent of babies born by v back and point eight
percent of moms who had repeat C sections experienced severe bleeding,
while two point three percent of those who gave birth
vaginally did. And the thing is that these risks might
sound very small. We're talking about like point eight percent.
That might not sound like a lot, but the differences
are statistically significant and things for moms to have serious

(14:20):
conversations with their doctors about as they're deciding the kind
of birthing method that is best for them. So, all
that being said, how many C sections are safe for
a woman to have? Dr Roger harms his name is
Dr harms Over at Mayo Clinics said that while there's
not a ton of research out there about this, most

(14:40):
women can safely have up to three C sections, although
each repeat C section is generally more complicated than the last.
I mean, think about it. Let's let's put it in
terms of any surgery you keep having the same surgery
and complications could arise. And so the primary concern when
you're having repeat c sections is weaken uterine wall, problems

(15:01):
with the placenta, such as implanting too deeply in the
uterine wall or covering the cervical opening which is placenta previa.
There's also a risk of bladder injuries and heavy bleeding. Now,
when I feel like a lot of times when we
think about or hear about C sections, a lot of
times it is with all of these warnings and concerns

(15:22):
over whether or not it is good for the mother
and the baby we we I think we still tend
to frame it in our minds as this kind of
emergency procedure. But in developing nations, some research has found
that it could really improve maternal health outcomes. There is
an article that came out in the New York Times
in May of twelve which talked about how performing C

(15:43):
section deliveries extensively and forty nine poorer nations could save
almost seventeen thousand mothers lives each year and prevent many fistulas,
which are internal tearings happen during prolonged labor, and in
most country the operation would save two to six times
the cost and income created by mothers who would otherwise

(16:05):
have died or would have been disabled. So as c
sections maybe on the rise in more developing nations, as
some NGOs and nonprofits look into giving doctors local doctors
the resources to do that, it's sort of mirroring a
pattern that's going on in the United States and the
Western world of c sections being on the rise. But

(16:28):
there is all this debate around these rising numbers as
to whether or not this is cause for concern because
a lot of it has to do with the fact
that women are outright asking for c sections once they,
you know, learn that they're pregnant and everything. They're saying, oh,
you know what, we're gonna go ahead and schedule this delivery.

(16:50):
But first, um, let's talk more about the how much
that rate has risen. So c sections are actually the
most common procedure done in operating rooms now and between
two thousand seven the rate jump from tot of all births.
That's coming from a US News and World Report article
in September, And what's surprising to a lot of researchers

(17:14):
is that the C section rate is actually very high
for first time mothers. That's one of every three new
moms getting one. Yeah, and some gynecologists are are really
concerned about this. For instance, Robert Barbiera, who's the chief
of obstetrics and gynecology at Brigham Women's Hospital, says that
the rate should be more in the range. And those

(17:36):
concerns are stemming from whether or not these women are
undergoing unnecessary major medical procedures. Because a C section is
a surgery. You undergo anesthesia and incisions are made. We've
described the process, and so some doctors are concerned that
we are almost doing too much in that regard. Okay,

(17:59):
so why why this increase? A Time article in August
of looked at possible reasons, and some of those include
the rising rate of multiple births, more obesity in pregnant women,
the older age of mothers urging women some doctors are
urging women to undergo repeat c sections, and an increase
in induced labor up from ten percent of deliveries in

(18:22):
nineteen nine to more than two in two thousand and six.
And going into this research, I didn't think induced labor
had anything to do with C sections, but it sure does.
Doctor Debrah Arenthal did a study of induced labor and
found that nearly forty of cases of induced labor were elective,
and she says that reducing elective labor induction could lower

(18:44):
the C section rate in the US by as much
as twenty Yeah. And one of the ways that the
American College of Obstetricians and Gynecologists, for instance, is looking
at lowering the C section rate is by urging doctor
is to attempt what's called a trial of labor. Essentially,
a woman comes into the hospital to have a baby,

(19:07):
and the plan is, Okay, we're gonna try for a
vaginal birth, but we're gonna have everything in place for
a C section if necessary. So you're gonna really, really
really really try, but we'll do a C section if
it comes to that. Thus, at least giving it I
don't know, I guess giving it a college try, giving
it the old college try. Um. One other interesting thing

(19:31):
about the rates of c section is that they do
differ so widely between hospitals, and part of that is
just different doctors are encouraging different things. Um. This is
coming from a study in Health Affairs in March of
this year. C section rates range from as low as
seven percent in some hospitals to as high as seventy percent,

(19:51):
and other u S hospitals, and even among low risk pregnancies,
those rates varied. They the study authors right, vast differences
in practice patterns are likely to be driving the costly
overuse of cesarean delivery in many US hospitals. And now
here's why. Because I was like, Okay, well, what's what's
really the concern? I mean, yes, obviously we have a
health concern with women undergoing unnecessary procedures, but they point

(20:14):
out because Medicaid pays for nearly half of US births,
government efforts to decrease variation are warranted. M m uh. Well,
the newest wrinkle to arise and all of this, as
I have now mentioned a few times on the podcast,
is this whole elective factor of women taking a bit

(20:36):
more ownership over the whole childbirth process in terms of saying, hey,
you know what, I want to sign up for a
C section. And the funny thing is, I feel like
it's getting a lot more press in the past few years,
and uh as being this new medical trend. But we
found a two thousand one USA Today article reporting on

(20:57):
the quote unquote whole new trend of patient choice cesareans,
but I mean it's definitely something that is picked up,
and when those numbers were first starting to pick up
in the early two thousand's, physicians were very reluctant to
agree to it. There was an article in the journal
Birth from two thousand four I talked about how without

(21:18):
a clear medical indication, most practitioners who were surveyed wouldn't
perform a C section, and that was based on a
survey of one hundred and seventy physicians. But there was
an interesting difference among who gave a thumbs up or
thumbs down to elective c sections. Physicians who were men

(21:39):
and had patients with higher socio economic statuses were more
likely to give the thumbs up to an elective C section.
And I feel like that links to this whole stereotype
of as our UK listeners might have her being too
posh to push that is this thing that oh, well,
you know, ladies who lunch just want to pencil in

(22:00):
fitting in the birth between a manny and a penny. Yeah. Well,
and also thinking about the whole Marissa Meyer, CEO of Yahoo,
who literally like scheduled her birth with a very limited
maternity leave and was back at work, I mean the
whole kind of you know, let's put it on our
Google calendar and go, well, so, what does the American

(22:21):
College of Obstetrics and Gynecology say about this? What? You know?
What were they weighing in on? And they said that, look,
if the woman is informed and gives adequate informed consent,
and the doctor believes the C section promotes overall health
and wellness, then the surgery is ethically justified. But doctors
are saying should we even do it? There was a

(22:42):
discussion on the Royal College of Obstetricians and Gynecologist site
and the UK's National Institute for Health and Clinical Excellence
abbreviated NICE UH in two thousand four said that when
a woman requests a C section because she has a
fear of childbirth, she should be offered counseling such as
cognitive behavioral therapy to help her address those fears. But

(23:05):
in NICE turns around and gives new guidelines that say,
for all women requesting a C section, if after discussion
and offer of support of vaginal birth is still not
an acceptable option, offer a planned cesarean section. And that's
a definite change from when they said previously. Maternal request

(23:26):
is not on its own an indication for cesarian section,
and that seems like a positive development. I mean, I
feel like these are issues where obviously you and I
can't speak from first person experience, but the thought of
having a child and not having that much ownership over yeah,

(23:46):
how I do it would make me uneasy. And I
can understand how doctors might say, Okay, you're you know,
you're clearly just terrified of the pain of childbirth. Lets
you know, educate you into what actually goes into all
of this. Maybe a C section isn't really you know,
what what you think it is, but it does seem

(24:07):
like they're there. The fact that elective c sections are
becoming more accepted medically and socially is a positive thing
for women, although Veronica Vergeron in the journal Bioethics in
two thousand seven would argue the opposite, and from a
feminist standpoint. Now, when you send me the link to

(24:29):
her paper in Bioethics talking about how elective c sections
are actually bad for women, um, I was surprised because
I would assume that the feminist standpoint on you know,
childbirth would be choice, choice, choice, you know, whether I
want to be at home with a dula, in a
hot tub, having my baby underwater, or in a highly

(24:50):
medicalized environment in the hospital, scheduling that baby and getting
out of there. No Vergeron says that the medical it's
just medicalization of childbirth that is terrible. She says it
reflects a sexist bias with regard to conceptions of the body.
And you know, we mentioned informed consent earlier that a
Cox said, Hey, you know, as long as there's informed consent,

(25:13):
go ahead. She said that that can't be meaningfully exercised
unless women are made aware of the sexist underpinnings of
the medical model of childbirth, which she explains as the
exclusively feminine attributes of child bearing make it particularly vulnerable
to appropriation by a male dominated medical profession and a

(25:35):
patriarchal culture. Well, I mean, she has a point if
we go back to say when James Miranda Stewart Berry
was cross dressing in order to get into medical school
because women were not allowed in medical school in eighteen
o nine. And uh, I mean, and it has been
it's only been in you know, the past fifty years

(25:56):
really that women have been catching up to men numbers wise,
in medicine. But it's it's almost looking maybe too too
deeply into what's going on when we were talking about
like our health and our body, is um a patriarchal
past worth dismissing the present if that makes sense. Yeah,

(26:20):
I agree with you. This whole conversation though, too, about
this medicalization of childbirth, which to meet in the back
of the whole paper was you know, you should be
having a natural childbirth. People what to do? That's what
I'm saying. It's such a chopper, becomes such a complicated issue,
and we're not even gonna get into breastfeeding in that

(26:41):
whole debate. You know, it's like I would think that
we should embrace as women, we should be embracing the
choice of elective c sections. Because there was also the
Salon essay that I felt like stood in such sharp
contrast to bergeron Um. It was by Page Parker not
too long ago, about her planned C section and what

(27:03):
relief that she felt when she kind of allowed herself
to say, you know what, I don't want to have
a vaginal delivery. She was hoping actually that her baby
was breached with the feet down so that the doctor
would have to do perform a C section, and that
you know, she felt a lot of guilt at first
for wanting that right, but was so relieved, was so relieved,

(27:26):
although she did follow up at the end by saying
it was insanely painful recovery and because friends of hers
had warned her that she was crazy for wanting a
C section because the recovery is a bit more intensive sometimes. Um.
But just even having that choice leading up to the
delivery and the childbirth UM seemed to make a big difference.

(27:47):
And again, I mean, this is also one of those
conversations where every woman's situation is going to be different.
You know, we don't want a blanket thing of saying,
you know, only c sections, only vaginal births, only hot
tubs and sensual music in the background. Apparently it really
I've been thinking clearly about about baby having. I don't know.

(28:08):
I just the whole time I was reading Burton's essay,
I I pictured her with like one hand on a hip,
in the other hand like pointing accusingly at me. Right,
which is the opposite? I'm sure of what she's actually
advocating for. Right, I would I would hope, Well, we'd
hope because I certainly would not want someone using the

(28:29):
guys of feminism to tell women what to do. That
that's ah, that wouldn't be good. Yeah. Well. One instance
of when someone is going to tell you what to do, Kristen,
is when you have to have an emergency or an
unplanned c section. The doctor is going to be like, listen, lady,
this baby's coming out. So what circumstances are we in

(28:53):
when we have to have an emergency c section? The
most common reason is that a woman's labor is not
progressing and so they have to get the baby out.
Other reasons include the baby not getting enough oxygen, the
baby being in that abnormal position, breach the feet or
the buttocks being first in the birth canal or transverse,
and that baby is a little you know, like football player,

(29:14):
and he's trying to like go out sideways through his shoulder.
I don't know, I don't know if that baby is doing.
Another reason could be that you're carrying multiples, because it's
common for one to be in an abnormal position, although
you don't actually have to have a c section when
you're having multiples. A New York Times reported in February

(29:36):
that there was no difference in outcomes between vaginal and
C section deliveries for mothers of multiples, and that the
serious medical problems were completely even between births like they
were just there were thirty six serious medical problems for
C section babies and thirty five for vaginal birth deliveries.
So yeah, and that's a pretty significant development because the
thinking had been for a long time that with multiples

(29:58):
probably gonna go with the C section precisely. So other
times you're going to have to have an unplanned or
emergency c section, include like we mentioned earlier, there's a
problem with your placenta, either placental abruption or that placenta previa.
There could be a problem with the umbilical cord, or
you or your baby has a health condition or concern,

(30:18):
And I would be curious to know though, which is
more common for doctors to tell, you know, expecting mothers
say you're going to have a C section even though
you want you've requested a vaginal delivery for X, Y
and Z, Or for a doctor to say, no, we're
gonna try for a vaginal delivery even though you've requested

(30:42):
a C section. Yeah, I wonder. I'm really curious to
hear from listeners about that issue of you know, whether
how how much I guess negotiating power you really have
with the doctor in terms of what which kind of
delivery method you go for. Yeah, and I'd be interested
to hear from the moms out there. Did you go
into the hospital expecting one thing and you got the other? Oh,

(31:04):
I'm sure. Yeah, I would imagine that the number would
be pretty high because with the trial of labor situation,
when you go into the hospital intending to give the
old college try to a vaginal birth and then they
have to do a C section, it's a double digit percentage,
I'm pretty sure. So now is the time, though, we
need to hear from listeners out there who can speak

(31:27):
first person to the C section scenario and also to
the women who have written in though asking for you know,
more info on c sections. We hope this has helped.
It is a pretty in depth topic, but we tried
to touch on as much stuff as we could and
for etymology nerds, correct everyone about the old Julius Caesar

(31:49):
myth not true. So yeah, send us your letters, mom
stuff at Discovery dot com is where you can send them.
You can also message us on Facebook or if you
have a quick quip. You can tweet us at Mom's
Stuff podcast. And now back to our letters. Yeah, here's
one from Sean about our women's basketball Coaches episode. My

(32:13):
thoughts were along the lines of youth coaching, he says,
in the division of household labor, You've mentioned on several
previous podcasts that the division of household chores is becoming
more equitable, but that it's still not even close to
even I wonder if this leaves dads with more to
volunteer as youth coaches. That, along with the preconceived notion

(32:33):
that guys know more about sports than girls, something I
know my younger sister hates, means that women aren't going
to get the fake till you make it benefit of
the doubt that men would. Because, let's face it, many
youth coaches are far from experts ps. Shawan says, pat
some it is truly amazing and belongs on the mount
Rushmore of American coaches, not women's coaches, are basketball coaches,

(32:56):
but all time, any sport, any gender coaches. So thanks
for your thanks for input shown that's interesting. I hadn't
thought about the division of labor thing. Well, I've got
one here from Carmen, who played women's soccer in college,
and she writes, I dealt with many of the issues
you described regarding the male versus female coaches. I had
a female coach for the first two years, who was, unfortunately,

(33:19):
one of the worst coaches I've ever dealt with. This
prompted one of my teammates to write a public blog
post about how women's teams ought to have male coaches
because men are less prone to being overemotional or engaged
in petty fights with the players. This is a shocking
statement to me, since I have had many good and
bad coaches of both genders during my lifetime, and in

(33:39):
two thousand nine when this happened, we ought to have
progressed past the idea that women can't be coaches. Luckily,
my school had a female athletic director who had been
a coach herself for many years, and after discovering the
blog post, she gave my team quite a speech about
how hurt she was that the blog post has missed
all of her hard work as a coach and promoted
the idea that women are inherently incapable of leading a team.

(34:00):
Looking back, I think the most important thing I took
away from that experience is that women are often the
ones holding themselves back from achieving more. My female teammate
publicly wrote about how my female coach was a bad
coach because she was female. But women need to support
each other and not promote those kinds of stereotypes. So
thanks so much for this podcast and all the other

(34:21):
ones you do. That's true. Ladies helping ladies and men
and men can help lads do. Let's all just help
each other. Let's all hold hands around the globe, except
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(34:41):
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(35:05):
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