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The technocratic and holistic models of birth compared.

"The uterus is a muscular organ that is covered, partially, by peritoneum, or serosa. The cavity is lined by the endometrium. During pregnancy, the uterus serves for reception, implantation, retention, and nutrition of the conceptus, which it then expels during labor."

Cunningham et al., Williams Obstetrics, (1989:877)

The Technocratic Model of Birth

Male perspective Male-centered Women=objects Male body=norm Female=defective male Classifying, separating approach Mind is above, separate from body Body=machine Female body=defective machine Female reproductive processes are dysfunctional Pregnancy and birth inherently pathological Doctor=technician Hospital=factory Baby=product Baby grows itself through mechanical process

Fetus is separate from mother Safety of fetus pitted against emotional needs of mother Best interests of mother and fetus antagonistic Supremacy of technology Importance of science, things Institution=significant social unit Action based on facts, measurements Only technical knowledge is valued

Appropriate prenatal care is objective, scientific Health of baby during pregnancy insured through drugs, tests, techniques Labor=a mechanical process Time is important; adherence to time charts during labor is essential for safety Birth must happen within 26 hours Once labor begins, it should progress steadily; it is doesn't, pitocin is necessary Some intervention necessary in all births

Pain is unacceptable Analgesia and anesthesia for pain during labor Environmental is not relevant Uterus=an involuntary muscle Woman in bed hooked up to machines with frequent exams by staff is appropriate Once a Cesarean, always a Cesarean for many women VBAC high risk Cesarean for breech Birth=a service medicine owns and suppliers to society Obstetrician=supervisor/manager/skilled technician The doctor controls Responsibility is the doctor's The doctor delivers the baby

The Wholistic Model of Birth

Female perspective Female-centered Women=subjects Female body=norm Female normal in own terms Wholistic, integrating approach Mind and body are one Body=organism Female body=healthy organism Female reproductive processes normal, healthy Pregnancy and birth inherently healthy Midwife=nurturer Home=nurturing environment Mother/baby inseparable unit Intimate connection between growth of baby and state of mother Baby and mother are one Safety of baby and emotional needs of mother are the same Good for mother=good for child Sufficiency of nature Importance of people Family=essential social unit Action based on body knowledge and intuition Experiential and emotional knowledge valued as highly as or more than technical knowledge Best prenatal care stresses subjective empathy, caring Health of baby insured through physical and emotional health of mother, attunement to baby Labor=a flow of experience Time is irrelevant; the flow of a woman's experience is important Labors can be short or can take several days Labor can stop and start, follow its own rhythms of speeding up and slowing down Facilitation (proper food, effective positioning, support) is appropriate; intervention usually inappropriate Pain is acceptable Mind/body integration, labor support for pain Environment is key to safe birth Uterus=responsive part of whole Woman doing what she feels like - movement, sexual play, eating sleeping - is appropriate Vaginal birth after Cesarean normal VBAC low risk, normal Hands and knees for breech Birth=an activity a woman does that brings new life Midwife=skillful guide The midwife supports, assists Responsibility is the mother's The mother gives birth to the baby

These models are based in part on Barbara Katz Rothman's (1982:134-140) explication of the "medical" and "midwifery" models of birth, and in part on my own readings of obstetrics and midwifery texts and interviews with mothers, midwives, and medical personnel.

Robbie Davis-Floyd holds a Ph.D. in cultural anthropology, specializing in medical and symbolic anthropology and the anthropology of reproduction. Her book Birth as an American Rite of Passage will soon be published by the University of California Press.
COPYRIGHT 1991 Association of Labor Assistants & Childbirth Educators
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Copyright 1991, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Author:Davis-Floyd, Robbie
Publication:Special Delivery
Date:Dec 22, 1991
Words:615
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