Women, Power, and Childbirth : A Case Study of a Free-Standing Birth Center

Based on her 12 year study of a free-standing birth center, Turkel analyzes the medical model of childbirth in contrast to the midwifery model. In the medical model of birth, women are defined as patients and birth takes place in hospitals where women have little, if any, control over their experience. The midwifery model views birth as a healthy process where midwives act as teachers and guides for women during pregnancy and birth, helping women and their families to shape and define their experience to meet their needs and expectations. Under existing legal and cultural circumstances, free-standing birth centers face a dilemma. They must continually accomodate the medical model while trying to maintain the midwifery model and give women an option to home birth or to hospital birth. Contents......Page 8 Acknowledgments......Page 10 1 Introduction......Page 12 Technocratic Perspectives......Page 24 Political-Economic Critiques......Page 27 Scientific Objectivity as Ideology......Page 29 Science, Technology, and Childbirth......Page 35 The Hospital, Risk, and Technology......Page 42 Scientific Rationale......Page 51 The Experiences of Birthing Women......Page 56 Childbirth as a Feature of Social Relations......Page 60 4 The Midwifery Approach to Birth......Page 64 The Midwifery Model......Page 65 Professional Autonomy and the Role of Law......Page 68 Institutional Control: The Case of Nurse-Midwifery Associates......Page 75 Consumer Involvement......Page 79 Discussion......Page 81 5 Free-Standing Birth Centers......Page 84 Birth Centers and the Medical Model: Issues of Power and Control......Page 86 Statistical Data: The National Birth Center Study......Page 92 Discussion......Page 95 The Setting......Page 98 Babyplace......Page 101 A Different Strategy......Page 105 Discussion......Page 114 Introduction......Page 120 Basic Operation of the Birth Center......Page 121 Birth Center Clientele......Page 128 Birth Stories......Page 131 Discussion......Page 138 8 The Birth Center and the Medical Model: Accommodation and Resistance......Page 140 Third-Party Reimbursement......Page 141 Malpractice Insurance......Page 144 Opposition from the Board of Medicine......Page 149 Dwindling Client Base......Page 151 Discussion......Page 154 9 Reappropriating Birth......Page 156 Constrained Progress......Page 161 Reappropriating Birth: Short-Term and Long-Term Goals......Page 162 The Importance of the Birth Center for Women and Families......Page 166 Bibliography......Page 170 C......Page 176 G......Page 177 M......Page 178 P......Page 179 U......Page 180 W......Page 181