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1. ALONE AMONG STRANGERS: The Medicalization of Childbirth
- The University of North Carolina Press
- Chapter
- Additional Information
1 * alone amonG sTranGers The Medicalization of Childbirth The vast majority of American women (99 percent) currently deliver their babies in hospitals, accompanied by their physicians, nurses, and midwives and often by their husbands, partners, family, and friends. The hospital routine is fairly standard, although variations exist among hospitals, and medical protocols have been developed for most exigencies . Many women discuss the possible procedures in advance with their physicians and midwives and, within prescribed limits, make birth plans outlining their choices about what might happen to them during labor and delivery. Once labor begins, however, some women find that their desires are ignored, either because a different physician happens to be on call or because the course of their labor necessitates unexpected specific interventions. Because of the need for medical assessment on the spot, often more decisions are left to the hospital and the physician than to the woman or her family.1 This kind of “medicalized” childbirth is relatively new, a product of the twentieth century. Even though we have come to accept it as typical, the 22 * alone amonG sTranGers historical record is very clearon how recent a phenomenon it is for physicians to be in control of labor and delivery and for women to bow to their expertise. Before settling in with the fathers for the rest of the book, this chapter reviews the broad trends in American childbirth and examines how and why and under what conditions such hospital-based, physiciandirected , medicalized childbirth evolved. In the process, it lays out why mid-twentieth-century birthing women came to want their husbands to accompany them through labor and delivery in the hospital. Traditional Childbirth For most of human history, childbirth was exclusively a woman’s event. When a woman went into labor, she “called her women together” and left her husband and other male family members outside. “I went to bed about 10 o’clock,” wrote William Byrd of Virginia in the eighteenth century, “and left the women full of expectation with my wife.”2 Only in cases in which women were not available did men participate in labor and delivery, and only in cases in which labor did not progress normally did physicians intervene and perhaps extricate a dead fetus. A midwife orchestrated the events of labor and delivery, and women neighbors and relatives comforted and shared advice with the parturient. Ebenezer Parkman wrote in the middle of the eighteenth century of one of the twelve times his wife was “brought to bed”: “My wife very full of pain. This Morning I sent Ebenezer for Mrs. Forbush. . . . A number of Women here. Mrs. Hephzibath Maynard and her son’s wife, Mrs. How, Mr. David Maynard’s wife and his Brother Ebenezer’s, Captain Forbush’s and Mr. Richard Barns’s. My son Ebenezer went out for most of them. At night I resign my Dear Spouse to the infinite Compassions, all sufficiency and sovereign pleasure of God and under God to the good Women that are with her, waiting Humbly the Event.”3 Mary Louise Fowler wrote to her pregnant sister Nettie in 1863, when Nettie was in Europe with her husband: “I think of you in anticipation of your coming trial. I know you will have all that can be procured under the circumstances, but it would relieve me of great anxiety if you were in our best bed-room where I could nurse you as only a mother or a sister [3.95.233.107] Project MUSE (2024-03-19 04:20 GMT) alone amonG sTranGers * 23 can.”4 The ethic of a proper childbirth was, for the overwhelming majority of women in the United States, rich or poor, and over a long period of time, a home birth attended by caring, concerned women relatives and friends. One mid-nineteenth-century woman put it this way: “A woman that was expecting had to take good care that she had plenty fixed to eat for her neighbors when they got there.Therewas no telling how long they was in for. There wasn’t no paying these friends so you had to treat them good.”5 To this women’s world husbands, brothers, or fathers could gain only temporary entrance. In one instance, a new father was invited in to see his wife and new daughter, but then, “Mrs. Warren, who was absolute in this season of female despotism, interposed, and the happy father was compelled, with reluctant steps, to quit the spot.”6 The women...