A few months ago I developed a research proposal in social psychology on something that might seem entirely removed from my practice as a lawyer: the psychosocial mechanisms that influence how Spanish women choose their type of childbirth (medicalised or not). I want to be clear from the outset: the research was not intended to assess which type of birth is better or worse — that is a medical and personal decision that belongs to each woman and her healthcare professionals. What interested me was something else: understanding why people choose what they choose, and whether that choice is truly as free as it appears. In fact, the mechanism we analysed applies to a wide range of situations we encounter daily in legal practice.
More than 99% of births in Spain take place in hospitals and are medicalised. The caesarean rate exceeds 26% — well above what the WHO considers clinically justifiable. Those numbers cannot be explained by medicine alone, and the hypothesis under investigation was that something else is likely operating in the decision-making process.
The classic explanation focuses on fear: women hear negative accounts of natural childbirth (from their social circle, the media, the healthcare system itself) and this reduces their confidence — their perceived self-efficacy — in their ability to go through it. It is a reasonable explanation, but an insufficient one. Is it really true that nearly 100% of Spanish mothers lack the resources to cope with natural childbirth? Statistically, that is hard to sustain. The research proposal sought to clarify what mechanisms shape the decision. As I say, the subject matter (natural or medicalised birth) was merely the vehicle for the study; what mattered was not the object of the decision but the decision-making process itself and its possible determinants.
The research proposed a second explanation — alongside fear, social in nature, complementary rather than exclusive: the «perceived social norm». It is not only that women are afraid, but that in their social environment (family, friends, healthcare staff) medicalised birth is simply «what is done». The norm does not prohibit natural birth; it turns it into something that requires justification, almost an act of defiance. And when expressing confidence in your ability to do something your group does not do is incongruent with your social identity, most people adjust their expressed self-confidence downward — a phenomenon known as «self-stereotyping». Not because they do not feel capable, but because saying so might place them outside the group.
So far, a psychosocial mechanism applied to a specific decision. But during the research, an observation emerged that changed the way I saw the problem: many of these women had not chosen medicalised birth under pressure. They simply did not know they had another option. In the midwife’s consultation, non-medicalised birth is not discussed. It is taken for granted that the birth will be hospital-based, scheduled, and medicalised. The alternative is not rejected — it is simply never presented.
That observation contains an idea that goes far beyond our study (which, as I say, was really about the mechanism of choice and the confirmation that a «normative path» exists), and far beyond medicine: the most effective social pressure is not the kind that pushes you towards one option. It is the kind that makes the other one invisible.
The Menu We Never See
Think about how we make decisions. We like to believe that we evaluate the available options, weigh up the pros and cons, and choose. But that process assumes something we rarely question: that we know all the options. What if the real constraint were not the pressure on our choice, but the prior editing of the menu?
There is an enormous qualitative difference between two situations:
- «I know an alternative exists, but the pressure of my social environment pushes me not to choose it.»
- «I don’t even perceive that there is an alternative.»
In the first case there is internal conflict, tension, a difficult decision. In the second, none of that: the person «chooses» calmly, convinced they are deciding freely, without suspecting that their menu of options arrived pre-edited. There is no discomfort because there is no dissonance. And that is what makes this second mechanism so much harder to detect — and so much more powerful — than direct pressure.
We believe we are choosing because we are selecting, but the options we are given are not all the options that exist; our perception of choice may be nothing more than an illusion.
This Happens Every Day in Business
I want to be clear: I am not making any judgement about childbirth (and that was not the object of the study); every woman must decide with her doctor what is best for her. What fascinated me is the psychosocial mechanism that may be operating behind the choice, because I have spent more than twenty-five years advising business owners, boards of directors, and shareholders in conflict — and what I have seen, again and again, is exactly this same mechanism at work in business decisions of enormous consequence:
The blocked shareholder who has spent three years in litigation. Two 50/50 shareholders who cannot reach an agreement. The conflict escalates. Each hires their own lawyer. Court proceedings begin. Years pass, value is destroyed, the relationship becomes irreparable. At no point did their lawyer, their social circle, or their own experience present mediation as a real option. They did not reject it; it simply did not appear on their map. Their «menu» had only two options: give in or litigate. The third — sitting down with a neutral professional to find a solution — was invisible, nonexistent.
The family business where no one says what they think. The founding father chairs the board. The children participate in management. There are tensions over strategic direction, succession, and profit-sharing. But in meetings nobody expresses their real position, because the implicit family norm («you don’t question the father in public») suppresses any expression of disagreement. The children do not lack judgement; they lack a space in which to express it without threatening their place in the family group. And because no one in their circle has ever seen a family business manage its disagreements with a mediator, that possibility simply does not exist in their universe of options.
The executive who stays silent in the committee. They can see the risks of a deal, but the rest of the committee supports it with enthusiasm. They say nothing, or say as little as possible, because expressing a contrary opinion would require «justifying themselves» — exactly the mechanism of normative pressure. Months later, when the deal fails, everyone says «nobody saw the warning signs». They saw them. What did not exist was a space in which to raise them without social cost.
The Invisible Alternative
In all these cases, the problem is not a lack of solutions. The solutions exist: mediation exists, the family business protocol exists, executive team facilitation exists. The problem is that for most Spanish business owners, these tools are not part of «what is done». And when something is not part of what «your group does», it is not just difficult to choose — it is almost impossible even to conceive of it as an option.
Social norms do not need to be explicit to be effective. Nobody tells the business owner «don’t go to mediation». They simply never tell them they can. Their lawyer talks about claims and defences. Their circle tells them stories of court cases won or lost. The media covers judgments, not settlements. The judicial system is «normal» in the same way that hospitals and medicalisation are «normal» for giving birth: not because it is the only option, but because it is the only visible one.
Changing the Norm, One Conversation at a Time
If social norms make alternatives invisible, how do we change them? The answer, paradoxically, lies in the same mechanism that sustains them: narrative.
In my research I documented how second-order negative accounts — the stories others tell us about their experiences — reinforce the dominant norm. But the mechanism works in both directions. Every story of someone who explored an alternative and came out ahead erodes the norm a little. Every person who says «I chose differently and I have no regrets» expands the menu of options for the next person.
The same is true of mediation and alternative dispute resolution. Every business owner who resolves a shareholder deadlock in two mediation sessions instead of three years of litigation — and talks about it — is changing the norm for their sector. Every family business that manages its succession with professional help and speaks openly about it is making visible an option that was invisible to others.
Normative change does not come from legislation, although legislation helps: the recent MASC reform, which makes an attempt at mediation mandatory before going to court, is an important step precisely because it forces visibility onto an alternative that the system had rendered invisible. Deep normative change comes from conversations, from nearby precedents, from the accounts of those who chose differently and were glad they did.
The Question We Never Ask Ourselves
The next time you face an important decision — in business, in your professional life, personally — ask yourself one question before you choose: am I choosing from all the options that exist, or only from the ones my environment has made visible to me?
If the answer gives you even the slightest pause, there is probably an alternative you are not seeing. Not because you are incapable of seeing it, but because no one around you has named it yet.
Sometimes the most valuable thing a professional can do is not solve your problem. It is to show you that you had an option you didn’t know existed.