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

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

Introduction to Part I

Sirpa Wrede

For feminist writers of the 1970s, maternity care, with its medicalized and alienating approach to birth, was an apt illustration of women’s oppression by patriarchal social structures. Their critical assessment of the treatment of women at birth led to a blossoming of academic interest in maternity care. Numerous studies were generated, first in Anglo America and somewhat later in other high-income countries. The majority of this early work examined the power relations between physicians, pregnant women, and midwives. As the field developed, research began to present a more complex picture of maternity services, and yet in most studies medical science and the medical profession remained central. Medical science was seen as the source of power for maternity care professionals, allowing hospitals and medical specialists to assume control of the conduct of birth.

This single-minded focus on power relations in maternity care was driven by the close links between researchers and the campaigns to reform birth practices that populated the social landscape when the academic study of maternity care was in its infancy. But the field is maturing. Thirty years after the first feminist exposés of the mistreatment of women at birth, maternity care research is becoming more closely linked to academic disciplines and to ongoing scholarly debates. As a result, new perspectives and new areas of inquiry are emerging. One of the more promising of these is comparative research on the politics of maternity care.

The chapters in this part represent some of the best new work in this area. These studies of the comparative politics of maternity care services present a more complicated, but more accurate, understanding of the way maternal health services emerge and are designed. The comparative data presented here show medical science to be just one among several important actors that influence the form and content of maternity care.

The five chapters in this section approach the politics of maternity care from different angles, but taken together they allow us to draw a shared conclusion: The organization of maternal health services is a contested domain where negotiations and struggles constantly occur. Maternal health services in the present-day societies of

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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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