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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.
E-Book Content
WOMEN, POWER, AND
CHILDBIRTH
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WOMEN, POWER, AND
CHILDBIRTH A Case Study of a Free-Standing Birth Center Kathleen Doherty Turkel
BERGIN & GARVEY Westport, Connecticut • London
Library of Congress Cataloging-in-Publication Data Turkel, Kathleen Doherty. Women, power, and childbirth : a case study of a free-standing birth center / Kathleen Doherty Turkel. p. cm. Includes bibliographical references and index. ISBN 0-89789-317-4 (alk. paper) 1. Birthing centers—United States—Case studies. 2. Childbirth— Social aspects—United States. 3. Childbirth—Political aspects— United States. I. Title. RG500.T87 1995 362.1 '982,00973—dc20 95-12839 British Library Cataloguing in Publication Data is available. Copyright © 1995 by Kathleen Doherty Turkel All rights reserved. No portion of this book may be reproduced, by any process or technique, without the express written consent of the publisher. Library of Congress Catalog Card Number: 95-12839 ISBN: 0-89789-317-4 First published in 1995 Bergin & Garvey, 88 Post Road West, Westport, CT 06881 An imprint of Greenwood Publishing Group, Inc. Printed in the United States of America
" The paper used in this book complies with the Permanent Paper Standard issued by the National Information Standards Organization (Z39.48-1984). 10
9 8 7 6 5 4 3 2 1
In Memory of My Grandmothers Helen Rucinski Grodzicki and Anne Green Doherty
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Contents
Acknowledgments 1 Introduction 2 Technocratic Ideology and the Medical Marginalization of Motherhood and Birth
ix 1 13
Technocratic Perspectives
13
Political-Economic Critiques
16
Scientific Objectivity as Ideology
18
Science, Technology, and Childbirth
24
3 T h e Medical Model The Hospital, Risk, and Technology
31 31
Scientific Rationale
40
The Experiences of Birthing Women
45
Childbirth as a Feature of Social Relations
49
4 The Midwifery Approach to Birth
53
The Midwifery Model
54
Professional Autonomy and the Role of Law
57
Institutional Control: The Case of Nurse-Midwifery Associates
64
Consumer Involvement
68
Discussion
70
5 Free-Standing Birth Centers Birth Centers and the Medical Model: Issues of Power and Control
73 75
Contents
Vlll
Statistical Data: The National Birth Center Study
81
Discussion
84
6 Case Study: The Founding of a Free-Standing Birth Center
87
The Setting
87
Babyplace
90
A Different Strategy
94
Discussion
7 The Operation of the Birth Center
103
109
Introduction
109
Basic Operation of the Birth Center
110
Birth