Medicalization of Childbirth

1. BACKGROUND In the 1700s, Barber-surgeons, predecessors of the accoucheurs belonged to a menial kind standing, like to that of carpenters and shoe correctrs, members of the arts and trade guild. In an get down to create aff satisfactory mobility and improve accessible status, barber-surgeons saw the opportunity to expand their expertness and redefined the perception of their accomplishment as bread and exactlyter saving, a uplifteder moral order. Soon, barber-surgeons gained a competitive edge all all over midwives to practice session at difficult home-deliveries, done manual(a) non- checkup-instrumental extraction of fetus from the p bentage charr (Dundes, 1987).Contrary to lay belief that foetal sprightliness began wholly at the point of quickening when expectant muliebrity felt fetal movement (20 weeks), Obstetricians utilized their bio-scientific k sequentialwayledge from the expertise of the microscope to claim that the start of perinatal purport b egins from the point of conception (Costello, 2006). This Interprofessional rivalry sparked opposite from the displaced midwives. However, English midwives succeeded in certifying midwifery practice with the 1902 midwifery act (Costello, 2006).This was an definitive step in establishing midwives not as doc-rivals, that as para- aesculapian examination exam exam subordinates. In the similar year, 1902, the Journal of Obstetrics and Gynecology of the British Empire was published (Drife, 2002). Early physician Mosher observed inverse relationship of declining richness and increasing abortion prescribe. He hypothesized that women opted for felonious abortion to avoid accouchement pain. This sparked general attention from cabaret to reduce the disincentives of vaginal birth. Hence, obstetricians machinate claims to be able to alleviate accouchement pain, creating a market for obstetrics.In 1900s, only 15% of deliveries were in hospitals (Jones, 1994), after the ministry of health grow maternal hospital facilities, hospital deliveries sored from 60% in 1925, to 70% in 1935 and 98% in 1950 (Loudon, 1988). This sharp increase in like manner correlates with the emergence of chloroform and ether as the first analgesics during the mid 1800s, followed by the melt fall Sleep consumer movement, of scopolamine and morphine, in the advance(prenominal) 1900s, championed by middle and upper trend women for fundamental rights to painless(prenominal) kidbirth.Under the guise of these womens rightist efforts, aesculapian exam examization of maternal quality and vaginal birth neuterd the orientation of childbirth to something un intrinsic, and created consumer demand for checkup intervention. Finally, the formation of popular health explosive charge systems, such as the NHS, in an plan of attack to provide welf ar-state equality to health care access, gained power over womens reproductive status and decisions. 2. INTRODUCTION Medicalization occ urs when a companionable problem is defined in aesculapian terms, descri fuck using medical language, understand through the adoption of a medical framework, or treated with medical interventions (Conrad, 2007). motherhood and childbirth has been subjected to the move of medicalization through increase medical jurisdiction and medical surveillance over these natural domains of life. There are threesome levels of medicalization conceptual, institutional, and interactional (Conrad, 2007). This essay explores r bring outes at which these three levels of medicalization stimulate been applied to maternalism and childbirth, and its consequences. 3. DISCUSSION 3. 1 Conceptual medicalization Pregnancy was an puzzle strictly confined to women, bit childbirth was a domestic shell attended by womanly relatives and midwives.This scoop and empowering experience opposed and threatened patriarchy, the superior culture of red-hot-fangled connection, creating a mixer problem of fem ale superiority. Hence, professional obstetricians emerged, eliminated midwifery, and created a medical model of practice that deem a disabling view on maternity and childbirth, allowing male partnership as womens salvation or at least, her equal. Medical authority and medical technologies endeavour to reduce the offstage and various(prenominal) experience of the women, and allow participation of men in the shared maternalism and childbirth experience.One way of removing power from the female experience is to prowl the focus away from adaptive sensible functions, to a desexualized and de in-personized throw experience, with intro of elements of patriarchy. The way of the women was further transportd through the carry of the lithotomy (dorsal recumbent) position and extradural anesthesia. The lithotomy position has the charhood lies on her back, facing the ceiling, with her legs separated and held by stirrups.She is given no visual or physical access to the birthi ng process, and no free access to movement. She merely allows. extradural anesthesia removes bodily sensations from the waist down. Hence, the birthing woman does not detect condensing signals from her carcass to bear-down and expel the child. She has to depend on obstetricians for objective data on her transporting progress. Risks and choices are similarly presented in medical terms, and then, women are unable to understand and make informed choices or negotiate participation in their pregnancy and childbirth process.Then, the woman is stripped of her individual identity and given identities based on the age, maternal co-morbidities, second of pregnancy (Parity), and point of metre in deli rattling (Gravid). These gives obstetricians biological information of the individual, allowing weaken assessment of the body and applying of the concept of take a chances to the oversight of care. Further more, the womans identity now revolves around the unhatched child. Her choice of sustenance and lifestyle is now dictated by the risks she is willing to put on the unborn child.The rights of child over mother are highly contested in the literature. by and by depersonalizing the woman, weakening the sexuality ideology at birth, an attempt to desexualize the birthing process is done by creating taboo and tenderness to the sexual nature of childbirth. In Midwifery techniques, hands-on perineal massage, which involves preparatory reaching of the vaginal passage and stimulation of the nipples and clit to elicit biological hormones that relaxes and lubricates the vaginal walls, supports natural spoken language.However, obstetricians attempted to remove suggestions of female sexual urge from the birthing process to allow involution of a male-dominated profession. Substituting the natural, with artificial injectable hormones (Pitocin) to arrive at labor caesarean section pricks to remove the child from an above-naval-abdominal surgery and episiotomies (cl ean incision and straight reunion of the skin, as opposed to a irregular natural tear) as a mark of the obstetrician. This hangs the empowering experience of the body and increases the habituation on external medical interventions.They too offer episiotomies and cesarean sections to intercede for the husband, who assumes sub judice access and possession of the body and sex activity of the birthing woman who has been destroyed by the birth of her child. Another practice to lucubrate presence of patriarchy is how technology reveals and shares the individual pregnancy experience of the pregnant woman with her husband, is through ultrasonography-enabled-visualization of the child in formation. As such, he pregnant women no all-night has authoritative knowledge over her pregnancy, but now engages in an more egalitarian relationship with her husband, an equal partner in the pregnancy experience. 3. 2 Institutional Medicalization Obstetricians became self-governing-businessmen thro ugh hugger-mugger practice. Their capitalistic motivations were achieved merely through their medical authority, and not through tuition in business management. They could determine the pillow slip of obstetrical interventions women of each favorable air division deserved.A 75% cesarean section rate among private patients compares to 25% among general patients in New York (Hurst and Summey, 1984). This suggests a loss in professional accountability of physicians treating divergent nonrecreational classes. Private obstetricians receive out-of-pocket fees straightway from their patients maintain continuity of care, a personal doctor-patient relationship is expected. Obstetricians become sociablely obligated(predicate) to direct- liquidateing patients hence they may exercise their skill of medical interventions in exchange for the fee, opulent medical procedures on women even in the absence of indication.Furthermore, the closer doctor-patient relationship of private practit ioners allows the professional to better evaluate the emotion-translated monetary willingness or financial ability to pay for additional cost of medical interventions. elevated information access through antepartum education and consultations positively correlates with high prenatal care and high cesarean judge (Hurst and Summey, 1984). Theoretically, increased prenatal care should decrease the risks of pregnancy and childbirth hence less medical intervention should be required.Hence, it is suggested that with medicalized care expanding its surveillance to the prenatal period, there is increased awareness of the dangers of childbirth complication, and of alternate birthing methods, putting high SES New York women at risk for choosing medical intervention, which carries surgical risks on its own. Interestingly, women of lower SES in public hospitals in India were too subjected to more medical interventions and became targets of political missions of population verify and subj ected to pressure to afford sterilization after delivery (Van Hollen, 2003).Another leading light finding was the extensive engage of drugs to induce labor, where drug-induced labor was a means of crowd- make, to free up maternity beds for new patients (Van Hollen, 2003). This cornerstone constraint defers from the picture of many modern western countries. In which extensive stem was built in more ample days, and with declining birth grade, more invasive medical procedures such as cesarean section ensures longer hospital stays, utilization of resources and sustaining jobs of healthcare workers in the maternal hospital (Hurst and Summey, 1984).By medicalizing pregnancy and childbirth, the state, through government hospitals and public policies basin effectively control the rate of rearing. Hence, it is seen in both social classes, obstetricians have different motivations for the medicalization of childbirth. Another factor fuelling the medicalization of childbirth is obstetri cians fear of malpractice suits. Government employers pay off obstetricians working in general hospitals, merely private practicing obstetricians do not receive this privilege. Hence, private patients are able to bring malpractice suits directly to the practitioner, and his practices reputation.Fear of malpractice suits are frequently cited for the increase in cesarean rates in New York (Hurst and Summer, 1984). Hence, private practitioners reduce the risk of being legally liable for unsuccessful or compound childbirth by relying on their skills and utilization authority to decide on medical interventions. Private practitioners alike pay a huge premium for malpractice insurance to cover charge for themselves. In New York, malpractice insurance premiums have risen from $3,437 to $50,000 over three decades (Hurst and Summey, 1984). practical application of costly medical interventions helps private obstetricians to cover this cost. . 3 Interactional medicalization Through the ethnical interaction between obstetrician and his patient, obstetricians attempt to control culturally deviant style medical and intervene with obstetric practice of medicine. Obstetricians routinize medical interventions as professional rituals to establish a sense of security and control over the unpredictable natural process of pregnancy and childbirth (Davis-Floyd, 2002). As part of the obstetricians professional duty, they experience the hurt prospect of the encountering a biological fault or a loss of human race life or biologically defective.Hence, when in the power to establish control mechanisms over nature, obstetricians instate medical interventions to protect themselves from emotional distress, from disability, finish or blame from their patients. However, Floyd fails to acknowledge the functionalist and emblematic interactionist perspective, where obstetricians may employ medicalization, not solely from the power of professional authority but for social service t o women, and a social duty maintain societys order.Simonds, 2002 points out that as small durations of time become socially importful, the perceived scarcity of physical time increases, perceived control of events in ones life decreases. This rightly illustrates increased value and meaning of the period preceding childbirth, as social pressure to produce a new functional member of the social group, on both women and obstetricians increases. Ultimately, medical interventions not only serve the interest of obstetricians, but also to women and society as a whole.For example, the change from trimester to weekly monitoring of pregnancy and the introduction of a scheduled hourly-charting at labor, does not merely enable increased medical surveillance and control, but also increases social contact which legitimizes womans sex activity role and addresses the valued significance of pregnancy and childbirth as social events. To the same(p) effect, the medical category expansion to complica te prenatal screening at dated-pregnancy-checkpoints is also a social piddleion influenced by the 20th century eugenics project.Prenatal screening allowed in-utero perception of biological defects such as crack lip Spinal bifida Downs syndrome, and determination of sex, this screening creates points of knowing for important decision-making. Through selective abortion another(prenominal) obstetric procedure, obstetricians and women play God, make choices on rejecting or accepting the child into the family and society. This stems from the desire to have a arrant(a) child in a eugenic society. Next, risks is defined by obstetricians, whether a women is or not allowed to have a shape birth.Medical students are taught in terms of the very dichotomous high or low risk assessment of pregnancy. Obstetricians are able to develop diagnoses to categorize deliveries as high risk. Previously, due to poor nutrition, women suffered from a atomic number 20 deficiency known as rickets, hence malformed pelvis caused difficulty in vaginal delivery (Drife, 2002). Now, doctors socially construct small pelvis as a diagnosis of cephalo-pelvic disproportion (Beckett, 2005). Women then see themselves as defective, blame themselves, hile doctors use this emotional-blackmail, threatening women of her bollockss death, usually into submission, hence legitimizing his obstetric power. Hence, obstetricians attempt to use objective criteria to chase the highly inbred definition of change or high-risk pregnancies. Another example is obesity. Women with obesity have higher rates of cesarean section (Beckett, 2005). Hence, these deviant behaviors are perceived as abnormal and have a higher rate of medical intervention.Obstetricians also exaggerate the dangers of childbirth (Cahill, 2001), implicitly suggesting the potential for complications and risks. It is suggested that women internalize gender systems such as knowledge, discourses and practices of the female norm and acts it out d uring childbirth (Martin, 2003). Middle-class women view themselves as relational, caring, selfless, and discipline their bodies to adhere to the prescribed gender identity. At childbirth, women may actively implore for medical intervention, such as analgesia, epidural anesthesia, cesarean sections under general anesthesia, to counter deviant behavior.This social driver for medicalization of childbirth is also reflected in the increased risk of childbirth portrayed by the media. Media continuously focuses on exaggeration, creation of a medical crisis. The birthing women agonizing in pain, the use of machines to denote life or death, and the swarming of medical personnel at the birth bed portrays an increase tension and risks at childbirth. Also, discussion reports home birthing, and finding of abandoned newborns as irresponsible, and linked to pathological child-abusers (Craven, 2005). . CONCLUSION Medicalization of childbirth and pregnancy is an attempt by society to maintain h egemony over the female body and the family, to perpetuate patriarchy, capitalism, vigilance and risk-caution as the plethoric culture. However, there is a vast difference in the motivations of this social process. Society sees divergence of gender as a social problem, hence it attempts to control female hyponymy through the medicalization of pregnancy and childbirth, experiences paramount of the female gender identity.Then, society attempts to control the reproduction of the population by structurally categorizing women correspond to their ability to access maternal facilities of care. The exaltation childbirth experience was then linked to the idea of Socio-economic status. Women, who could afford medicalized care, veritable the or so current and advanced technologies. While women who could not afford medicalized care often received less medical interventions, creating a subjective experience lesser than that of the already established norm of hospitalized painless childbi rth.Also, the state could more effectively control population addition through the authority of the attending obstetricians. Lastly, society attempts to control the ideal construction of a society, seeing the unpredictability of childbirth as a social problem, hence attempting to control it with an expansion of medical category to imply risk assessments such as prenatal screening and intensive monitoring of delivery process at childbirth. Society also sees the unruly behavior of women at childbirth as deviant and attempts to control it with medicine and medical interventions.