Childbirth in a Technocratic Age: The Documentation of Women’s Ex ...

Before I proceed to the details of each step on the pathway, a few general comments are in order. First, figure 1 by no means represents exhaustive coverage of available birth options. Instead, the figure reflects those features of and options along the childbirth pathway emerging as most salient in the reported childbirth expectations of my interviewees, who were all on the verge of living out the options they envisioned. Second, this model’s relatively linear structure is my own design; mothers spoke of their expectations in less circumscribed ways, and the figure represents those points they repeated or emphasized most strongly. Third, the figure’s linear organization lends the impression that one expectation flowed from the one preceding it, in stepwise fashion. Although steps along the childbirth pathway should theoretically be discrete—for example, the choice of in- versus out-of-hospital birth should be independent from the choice of an obstetric caregiver—maternal accounts revealed that in reality, choices and related expectations between and among certain steps are interdependent. As a general rule, however, maternal health and pregnancy status stood as the critical point from which other expectations flowed.

Maternal and Pregnancy Status Guide Other Expectations

Setting the stage for all further expectations along the childbirth pathway was mothers’ health in pregnancy and related status, a situation over which women have some, albeit limited, control. Fortunately, however, according to the World Health Organization (1996), 90–95% of pregnancies are “normal,” meaning that they are free of identifiable factors known to produce adverse birth experiences or outcomes. Consistent with that figure, in initial interviews, 68 (91%) mothers described themselves as healthy or as having only minor health problems that they did not expect to complicate the labor process, defining those mothers as low risk and perhaps driving their assumptions of surviving childbirth. In theory, low-risk mothers should be able to expect to follow any one of several childbirth pathways because low-risk birth can by definition be successfully carried out in various ways.