What happened to Natural Selection?

I was discussing the issue of Natural Selection with one of my best friends going back a couple of weeks ago. It was a lighthearted discussion yet since then I have used it more times than I can count on two hands.

As the Caesarean rate continues to creep to 30, 40, 50%, I have had to find some understanding beyond the cop-out that woman want them. Lisa Barrett discussed this very issue in a recent post which can be read here.

My plan, in my spare time (haha), is to do some research into birth history. My reasons for wanting to do this is related to wanting to know what happened to women and babies when the common obstetric complications of today occurred including CPD (if there was/is such a thing), shoulder dystocia, postpartum haemorrhage, high head, malposition, failure to progress and breech. Many of these are interconnected and are questionable in terms of the word 'complication' when much of the problems seem to be caused by insistent intervention but this post isn't addressing this issue (I will save it for another), instead I want to make comment about the outcomes.

In the event that this happened in history, what would the outcome be with the understanding that no testing, consistent monitoring, scans etc would have been available? I am expecting to find that natural selection would have become real and these issues would have resulted in the demise of the woman, baby or both. Its shocking for some people to contemplate this when we have todays technology but for me it is natures of way of choosing the 'fittest'.

So my question is, are we fighting natures intentions and therefore messing with Natural Selection? And does this have something to do with the rising section rate for the simple reason that women who would have died during childbirth because of physiological incompatibility are now given the opportunity to have babies who in turn carry the hereditary incompatibility and so on and so forth?

This way of thinking has ethical and moral consequences and was intended only as thoughts and ideas. It is the way of species to survive but what are the long term consequences? Particularly for midwifery...