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Passing a head through an opening too small for the task doesn't look appealing at all - I remember an account from Annie Lowery about a doctor cutting open her perineum as part of her delivery.

> The sense of being eviscerated, the room going Technicolor. I did not know I could feel so much pain.

> The extra anesthesia kicked in, so I keeled over in the bed as the doctor explained that he’d performed an episiotomy while wresting the baby out. I was insufficiently anesthetized at the time. “I’m sorry,” he said softly. [0]

And the alternative is getting gutted and sown back up.

But I can't help but suspect that it's the time pressure that really makes it infeasible. We can only juggle so much and it takes a lot of time to keep up with the demands of modern life.

Lack of religion/purpose is also probably huge. With all the reasons not to have kids, you probably need a good reason to, but maybe there isn't one.

[0]https://archive.is/ZsHIH#selection-1173.59-1173.281



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