What leads to many Caesareans is the "cascade of interventions" which might include unnecessary induced labor (e.g. if a mother is not dilating "quickly enough"), an early epidural, or continuous EFM. Many of these interventions, including the ones I listed, increase the likelihood of having a Caesarean.

In such a highly emotional situation, many mothers will feel pressured to do what their medical provider recommends. So, yes, it's technically true that it's the mother's decision, but many mothers don't realize they have the right to refuse these interventions, or are too scared to advocate for themselves in these situations, or are not fully aware of the risks -- both to the mother and the baby. In that sense, the decision is largely made by the medical provider, and this decision is often made because of an unnecessary urgency to get the birth done (or other reasons, such as a lack of experience with vaginal births or a fear of being sued, but in any case these reasons are not primarily the mother's). That is the part I was referring to as unethical.

To be clear, if it is medically necessary, a Caesarean should absolutely be done.

Many doctors nudge, or even push, decisions towards things that are convenient or good for them. Time table for the birth, treatment that enriches them... This includes unnecessary surgeries and labor inducement.

The decision is left up to the mother, sort of. Inside the hospital is an environment that the doctors are very familiar and the mother, not. It is very interested in following procedure, within which the doctors orders are held in high regard and the woman's desires not so much.

If you try to buck the desires of the hospital+doctor you had better have a will of steel and a willingness to walk out. Ornery nurses and doctors can make your stay an absolute hell.