Women, Power, and Childbirth

It would be an understatement to say childbirth is an intimate event. It is perhaps one of the most personal acts that can be witnessed. The act of birthing new life into the world is also a unifying event each made distinct by cultural beliefs and values inherent to the offspring's familial connections. Where births take place and how they are performed tell us a great deal about the receiving society's views about race, class, norms, family life, and technology. In a world that is technologically advancing everyday, there has been a rise in at-home and mid-wife assisted births over the last years in the United States.1 For those women who have complicated pregnancies, home births are not an option. However, given the choice, a large percentage of women are now freely choosing to have their children delivered at home or at birthing centers with the help of a midwife or doula. They are deliberately choosing convenience over technology at perhaps one of the most important moments of their lives.

The Role of the Midwife

Indisputably, the midwife's role can be traced through the ages. Writings from as far back as the 5th century B.C. as well as the Hebrew Bible have mentioned midwives.2 Like that of a doctor, the fundamental role of the midwife is to assist in the delivery of newborns. However, the midwife is much more than a delivery-person. The biggest component of the midwife-assisted versus hospital-assisted delivery equation is what the midwife brings to the table. Where the doctor's role ends, the midwife's picks up and continues. With just one patient to assist at a time, the midwife is more focused on the task at hand earlier on in the game. Her/his support is significant in comforting the pregnant woman and preparing her for what she is about to accomplish. The main objective of the midwife is to comfort and placate the worries of the woman in a nurturing and loving manner while avoiding the excessive use of invasive procedures as is common in hospital settings.3 The goal for both woman and midwife is to make delivery a pleasant, non-invasive, humanistic process.

Why Choose a Midwife

The larger social perspective is that pregnancy is a condition that requires continuous medical monitoring and intervention from various physicians, technicians, and nurses who employ a vast "variety of treatments, tests, and high-tech diagnostic tools to assess the health of the woman and the progress of her developing fetus."4 The pregnant woman is seen as a "patient" and her pregnancy as a "condition." Often, the hospital setting is not conducive to helping the woman achieve the optimum relaxation necessary to deliver her baby with as little complication as can be achieved. In fact, hospitals can be negative components in the birthing process as women often feel they're making too many demands on hospital staff and try to be quiet and not create problems for the staff.5

The Midwifery Approach

The differences between a midwife-assisted birth and a doctor-assisted birth are not vast. However, the differences of approach to the task in each setting are quite vast indeed and as such, the midwifery approach calls for a series of five principles that characterize and have come to encompass all that is the ultimate distinction between a doctor-assisted birth in a hospital and a midwife-assisted birth in a hospital or home. These are:

Continuity of Care - allows the midwife to get to know the woman deeply and develop a relationship based on trust. The impending

birth becomes a celebration not merely the culmination of a

process.

Respect for the Normal Ð'- showcases the midwife belief in the

normalcy of pregnancy and thus avoids the constant medical intervention women might experience during a hospital visit or

while in labor. This unwillingness to intervene in the natural

physiological process that is birth represents the rejection of technocratic ideology. In direct contrast to the technocratic

view, midwifery believes pregnancy and birth are natural

occurrences that should be dealt with naturally and not with

technological invasiveness.

Enable Women to Make Informed Choices About Medical Care Ð'- Midwives provide a source of emotional support and can work alongside obstetricians in the care of women who may experience complicated pregnancies. Even when the situation merits

technological intervention,