Casey has a Ph.D. in Sociology and has 15 years of experience in academia.
The Medicalization of Pregnancy
Defining birth as risky and dangerous is a way of legitimizing the disempowerment of those without obstetrical training making women's experiences during pregnancy and giving birth a less important issue in comparison to patient safety. This article will discuss feminist views of the medicalization of pregnancy and grassroots movements pushing for alternative forms of birth.
Feminist Views of The Medicalization of Pregnancy and Modern Changes
The psychological experiences of patients have become a focus of feminists and modern natural childbirth advocates as criticisms have arisen of medicalized ideas and approaches. Many feminist theorists have argued medical intervention in pregnancy and childbirth is unwarranted, is disempowering, and devalues women’s own abilities and experiences.
Feminists also argue that medicalization of pregnancy and childbirth is damaging for women by transforming a natural process into a disease. Modern proponents for alternative birthing choices focus on the goal that women should have a choice over their own birthing experiences (Johnson 2008).
Even though there is little focus on social and psychological aspects of biomedical birthing practices there have been some social benefits of the medicalization of pregnancy. The main social benefit is that medicalization has changed the role expectant fathers’ play in the pregnancy/birthing processes. Because of medicalization expectant fathers are encouraged to participate in the medicalized process with their female partners. In many societies, before pregnancy became so highly medicalized, social norms put the responsibility of pregnancy/giving birth mostly on females.
Currently, in America and many European countries, because of changing views, it is now normal for men to be active participants in medical processes. In Israel, the U.S. and European countries, within the last thirty years, medicalized views of birth have been adopted and there have been great changes in men's role in pregnancy/giving birth. Prenatal care is highly medicalized and men now participate in the medical process by encountering technology, practitioners, knowledge, and authority figures of reproductive biomedicine by accompanying their partners to prenatal care checkups, sonograms, prenatal diagnostic testing, and hospital births (Ivry and Teman 2008).
Patient Consumerism and Alternative Medicine
The rise of patient consumerism has also changed medical practices greatly in modern society and demand for alternative forms of care focusing on social/psychological benefits has increased. Natural childbirth supporters promote the idea that women should have rights as consumers over health care decisions and that childbearing women should have the ability to choose how they want their births managed and have authority over their own birthing experiences. In modern society there are more choices for health care targeted at giving consumers choices. Concerning pregnancy and childbirth, less medicalized practices are becoming popular.
Alternative birthing options being offered include childbirth classes, birthing settings that are personal and non-institutionalized, choices on what services to receive when giving birth, having choices as to how to give birth, along with numerous other options allowing patients to be consumers and design their own experiences. The rise of patient consumerism has allowed patients to gain some control over their own experiences. Because of the lack of control patients have under medicalized practices, there has been growing resistance towards medicalization (Zadoroznyj 1999).
Medicalization Still Dominates But Things Are Changing
The medicalization of pregnancy dominates medical practices in many societies worldwide but in modern history many societies have had increasing levels of patients rejecting medicalized care and there have been small movements by women to resist medicalized experiences during pregnancy and childbirth. There have been movements in the United States, Europe, Canada, and numerous other societies to favor more naturalistic birthing practices.
One example of this would be the usage of midwifery in Canadian society to resist medicalization. In Canada in the 1970s there was a women's health movement where women demanded control over their bodies, control over the experiences had during childbirth, the choice of where they gave birth, and the choice of who aided them in the birthing process (Perry 2008). The 1970s in Canada was a period where alternative birthing techniques that focused on intervention free births and partners’ assistance were being developed and embraced over more medicalized experiences (Inhorn 2006).
In the United States midwives have made major advancements through grassroots movements since the 1960s to become organized and develop training schools. Grassroots efforts focus on promoting the idea that women need to reclaim power over their own bodies and births. Efforts have mostly been supported by well-educated, middle-class women choosing to have home-births attended by midwives. In 2003, midwives attended four out of ever thousand U.S. births and around five out of ever thousand non-cesarean births. Even though there have been movements for alternative birthing choices, most births in the U.S. occur in hospitals, influenced by historical ideas about medically monitored births being safer even though there is a lack of evidence supporting this idea (Perry 2008).
Even though U.S. alternative birthing techniques are growing in popularity in other countries like Canada techniques like midwifery are not thriving. The economic market in Canada, when taking into account national health insurance, low birth rates, and surpluses of physicians and nurses, has not been conducive to aiding in naturalistic birthing techniques growing as a field. Midwifery and alternative birthing practices are constrained and not as successful because of Canadian economic conditions in comparison to the U.S. The U.S. has made major advancements in health care but in countries like Canada there is a lack of professional advancement and a lack of educational opportunities for individuals wanting to practice naturalistic birthing practices (Johnson 2008).
The medicalization of pregnancy and birth has had both negative and positive impacts in society. Because of medicalized practices, safer conditions and practices for pregnancy and giving birth in modern society exist. Technology today is better designed to treat a wide variety of conditions and the rate of successful pregnancies/births has steadily risen due to better medical practices and conditions. Even though the medical field is better in modern society than in the past the field isn't perfect and flaws still exist.
Because of medicalization, pregnancy is no longer looked at as a natural process occurring in women but as a danger and risk to women's health. The focus of medicine is now on increasing safety and reducing health risks but not on women's experiences on having children. Hospital births are impersonal environments where birthing practices are standardized and women have little control over medical practices.
Recently there have been movements to redefine pregnancy and childbirth by grassroots movements supporting alternative birthing practices. Support for alternative birthing practices focus on improving the social and psychological experiences of pregnant women and reducing the practices used by institutionalized medicine. Alternative birthing organizations are growing in popularity but births in hospitals still dominate. Hospital births continue to be seen as safer and physicians in hospitals are seen as providing the best and most knowledgeable care.
More About The Medicalization of Pregnancy
This article is the third in a three part series. To read more about this subject visit the links below.
Cahill, Heather. 2000. “Male Appropriation and Medicalization of Childbirth: An Historical Analysis” Journal of Advanced Nursing. 33(3): 334-342
Inhorn, M. C. (2006). Defining women’s health: A dozen messages From More Than 150 Ethnographies. Medical Anthropology Quarterly. 20(3): 345–378.
Ivry Tsipy and Elly Teman. 2008. “Expectant Israeli Fathers and the Medicalized Pregnancy: Ambivalent Compliance and Critical Pragmatism.” Culture Medical Psychiatry. 32: 358-386
Johnson, Candice. “The Political Nature of Pregnancy and Childbirth.” Canadian Journal of Political Science. 41(4):889–913
Kukla, Rebecca and Wayne, Katherine, "Pregnancy, Birth, and Medicine", The Stanford Encyclopedia of Philosophy.
Parry, Diana 2008. “We Wanted A Birth Experience, not a Medical Experience: Exploring Canadian Women Use of Midwifery.” Health Care for Women International. 29: 284-806
Rooks, Judith. 2006. “The History of Childbearing Choices in the United States.” Midwifery & Childbirth in America
Zadoroznyj, Maria 1999. “Social class, social selves and social control in childbirth.” Sociology of Health & Illness. 21(3):267-289
© 2020 Casey White