About a third of all deliveries in America are c-sections, and a majority of those are primary c-sections. The anti-natalism isn’t in women having c-sections so much as the pressure for women to accept a primary c-section. This wouldn’t be possible without the subtext that women shouldn’t have more than two children, three at most, a view that is standard American these days. It also wouldn’t be possible without the medical community downplaying the risks of c-sections. The reality is that c-sections limit how many children a woman can reasonably risk conceiving and carrying to term. While there are risks to naturally delivering seven or eight or ten children, those risks are significantly lower than the ones c-sections introduce through repeated surgical trauma and scarring. However, those risks don’t come into play for the average woman having c-sections until she’s looking at more than three of them. After three c-sections, the risk of losing the baby shoots up (the scarring makes it hard for the placenta to seat itself, increasing likelihood of fetal demise) along with the risk of premature delivery or catastrophic delivery complications like placental abruption.
This is not communicated to women when they are “encouraged” to have a primary c-section after say ten or twelve hours of labor. Thus, many women who would like to keep open the possibility of having a larger family are limited by a choice they were given misleading information about by medical professionals advocating approved choices rather than patients’ choices. It is possible to have 4-6 c-sections and deliver the children safely, but it’s also a range where health and life risks for both mother and baby come into play at rates exceeding 20%. For perspective, women are not allowed to attempt natural delivery after a c-section in most American hospitals (VBAC) due to a 1% risk of rupture (which baby and mother typically survive without complications). Yet women are not presented with the data that way. And they certainly aren’t told that a primary c-section means probably not having more than three or four children liveborn and term. A primary c-section is not terribly risky, and neither is a second one, compared to natural delivery. But they are slightly higher risk and on average harder to recover from than natural deliveries.
Combined with the delaying of childbearing, telling women in their late 20s and early 30s that a primary c-section is no big deal is to consign those women to fewer children than they might otherwise be able to have even starting in their early 30s and further, to leave them struggling with (on average) more difficult recovery while struggling with a newborn. That also leads to fewer children born at the margins. It’s just anti-natalist. This isn’t to say that c-sections, including primary ones, aren’t sometimes medically necessary. But many primary c-sections are a judgment call rather than “have to cut the baby out NOW”, and the judgment goes in one direction due to the general distaste culture-wide for having enough little taxpayers to fund society.