The Cultural Roots of the Canadian Birthing System

By James-Chetelat, Lois PhD | Pre- and Peri-natal Psychology Journal, Summer 1990 | Go to article overview

The Cultural Roots of the Canadian Birthing System


James-Chetelat, Lois PhD, Pre- and Peri-natal Psychology Journal


ABSTRACT: Cross-culturally, birthing practices can be better understood by examining the central belief system of a given culture. Through a discussion of the ideology, symbol, and value inherent within the central belief system of the Canadian society, that of science and technology, as well as by examining the historical development of obstetrics, it is possible to explain how a system of maternity care which over-emphasizes technology and de-emphasizes the woman's role in birthing has gained dominance in this country.

Birthing practices are adaptive. They evolve and change in accordance with a particular configuration of cultural, social, and economic circumstances. Integral to the development of birthing practices is the central belief system, world view, or "root ideology" of a given society. Traditional societies are legitimated typically by the "root ideology" of religion. According to Habermas (1971) it is science and technology which has provided the necessary belief system in the legitimation of contemporary Western societies.

An examination of birthing practices cross-culturally would indicate that there are two major perceptions of birthing. The first understands it as a natural process which may occur in the home, with little or no technical intervention, and under the supervision of a midwife. This approach to birthing tends to be found in traditional cultures although countries such as Holland continue to offer this type of maternity care.

The second perception of birthing is that it is a pathological event, requiring technical intervention by a physician within a hospital setting. I would suggest that it is the legitimation of science and technology as the "root ideology" which has been instrumental in the successful acceptance of this second birthing ideology within societies like Canada.

Anthropologists such as Cosminsky (1977) and Geertz (1961) have provided us with detailed research on birthing in other cultures. Yet, there has never been a major effort to link birthing practices such as those in Canada with the central belief system of the society. Often it is assumed that these practices are "pure" and "neutral," free from the influence of ideology, symbol, and value. In reality they reflect a particular world view. Only by examining the "root ideology," that of technical solutions determined by the impersonal forces of science, and the historical development of maternity care within Canada will we begin to understand how our birthing practices have evolved.

BIRTHING PRACTICES IN CANADA

In Canada, all babies except those whose mothers have chosen to defy the clearly established medical norms for birthing (less than 1% in Canada. Statistics Canada 1971-77) are born in hospital. A typical birth is characterized as physician-attended and professionally managed; each of which is oriented towards the use of medical technology and pharmacological methods to relieve pain. Birthing is a medical event. The mother, upon entry to a hospital, becomes a patient. All decision-making power and responsibility for her state pass from her to the hospital personnel and the physician in charge.

In Canada there is no institutionalized mechanism for separating the normal from the complicated births. Therefore all types of births are treated in the same manner. Although physicians may recognize that for a normal birth it is best to do nothing, the availability of medical technology to speed-up birthing, as well as their professional training and work orientation militate against such an attitude. The obstetrical ward itself is designed with a view to organizational efficiency and the availability of medical technology. It has a hospital-like atmosphere, one which is associated with suffering and illness. The woman upon entry into the hospital is frequently immobilized in bed although walking during labor is known to be both physiologically and psychologically beneficial. …

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