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

their associated birth attendants are forced to attend to the economic bottom line, which may mean using interventions to move more patients more quickly through labor and delivery. Contemporary medicine has also shifted its orientation from one of treating serious illness in its latter stages to intervening earlier, when the risk or signs of illness first arise. But pregnancy, labor, and delivery are not medical problems; they are normal physical processes that occur without complications in the vast majority of well-nourished women.

Certainly, I am not the first to note that contemporary obstetric treatment parallels aspects of early to mid-20th-century obstetric practice—particularly in the inappropriate use of interventions that lack sound scientific support. In the 1950s, obstetric nurses routinely positioned actively laboring mothers on their backs, strapping their hands, chests, and sometimes even legs to the labor bed to “prevent contamination of the sterile field” (Schultz, 1958, p. 152) before knocking them out with general anesthesia to erase memories of labor and delivery (Epstein, 2010). Might readers 50 years from now view early 21st-century rates of contemporary procedures like labor induction as similarly inhumane?

One bright spot in this otherwise gloomy picture of contemporary obstetric care is that today’s mothers have ethical and legal protections that arose partly from mid-20th-century treatment, including the right to access information on all obstetric medical procedures and nonmedical alternatives and the right to collaborate in decision making (e.g., ACOG, 2008; American Medical Association, 1990; Anonymous, 1977). Along with those rights, of course, come responsibilities, such as reviewing treatment information, making decisions for oneself, and remaining healthy. Birthing mothers, however, are responsible not just for themselves but also for their offspring, putting them in a complex position when it comes to medical decision making. If mothers assert their rights in the course of their obstetric care, they may be subject to internal and external criticism and even legal action (e.g., Colb, 2004) because they exercise their autonomy instead of complying with medical authority. If they submit to medical authority, they may eventually question their