Birth by Design: Pregnancy, Maternity Care, and Midwifery in North America and Europe

By Raymond Devries; Sirpa Wrede et al. | Go to book overview

Foreword

Robbie Davis-Floyd

The title for this book was chosen at a Midwifery Today 1 conference held in Salem, Massachusetts. Three of the contributors to this book—Raymond DeVries, Eugene Declercq, and I—were conference speakers. Our talks on that sunshiny day in the fall of 1997 fit well with the conference theme of counteracting negative stereotypes of midwives. Ray described his extensive research on the Dutch obstetrical system, which American midwives have long regarded with awe, envying the central place held by midwives in Dutch maternity care, the extensive governmental support they receive, and the 30 percent home birth rate they maintain (DeVries 1996, xiv-xix). Gene eloquently told the story of Hannah Porn, a professionally trained Finnish midwife whose life work was attending the births of the women of her immigrant community in Massachusetts in the early 1900s. Through extensive historical research, Gene had discovered that Hannah Porn had been repeatedly arrested and persecuted by the physicians in her area as they sought to cement their monopoly over childbirth, but had nevertheless continued to attend births, literally, until the day she died (Declercq 1994). And I gave a talk about the development of direct-entry midwifery in the United States, focusing on the challenges American midwives have faced and transcended during their process of professionalization (Davis-Floyd 1998). As it turned out, these topics foreshadowed many of the issues addressed in the book you now hold in your hands: the history of midwifery and the tension between the spiritual calling and the professional agenda that many midwives experience, the medicalization of reproduction and the dilemmas this has posed for midwives and for women, the diversity of cultural approaches to birth, and the embeddedness of birth practitioners in larger political and gender struggles over the question, “Whose knowledge counts?” 2

In the evening, Ray, Gene, and I sat down to discuss these larger issues and their relationship to this volume, the creation of which was but barely begun. Soon our discussion moved into a search for the right book title. We began with The Social Shaping of Maternity Care in Euroamerica. It was descriptive and accurate, but too long and too boring to serve as the actual title. We tried several variations, but none of

-vii-

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Birth by Design: Pregnancy, Maternity Care, and Midwifery in North America and Europe
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Foreword vii
  • Introduction: Why Maternity Care is Not Medical Care xi
  • Part I: - The Politics of Maternity Care 1
  • Introduction to Part I 3
  • Part II - Providing Care 113
  • Introduction to Part II 115
  • Part III - Society, Technology, and Practice 199
  • Introduction to Part III 201
  • Appendix 267
  • Contributors 280
  • Index 285
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