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

in ways that maximize objectivity. It is, however, only fair that I make plain certain of my biases related to this endeavor. My very choice to study pregnancy and childbirth shows a bias towards the topic itself, one that I have maintained since I enrolled in my first undergraduate psychology course.

Because of that interest, I sought graduate and postgraduate clinical training in major urban medical-center obstetrics and gynecology, neonatology, and pediatrics units. I did consultation-liaison work—that is, physicians requested my psychological assessments or intervention services when needed. In obstetrics, my cases included, for example, mothers with little or no social support, women whose psychological status raised questions about their safety or their ability to parent, and mothers grieving fetal or neonatal death. From those experiences, I learned firsthand about the enormous institutional pressures under which obstetric caregivers work. I also learned that on occasion, mothers present needs that no institution or professional could meet. In contrast, I witnessed more than one instance of poor maternal care by professionals who were overextended or who were ill suited to the caregiving role. I often heard mothers speak of feeling they had been unheard in some major or minor way during labor and delivery.

The sum of those experiences led me to develop a generally negative view on hospital birth. With that as the backdrop for my own pregnancy, I planned a home birth with a midwife whom I believed would listen and attend to my concerns. I chose this route also because I wanted to avoid routine hospital obstetric procedures that I considered unnecessarily risky. I realize that choosing that route depended on my relative advantages in terms of overall good health, supportive family members, reasonable health insurance, and access to good midwives with hospital connections. I am fully aware that many women, my own relatives and friends included, would not find such an approach acceptable for themselves, even if it were available. My own choice, however, does not correspond to wholesale opposition to hospital birth or obstetric intervention: I believe women and newborns benefit from having more rather than fewer options, and I would like to see a greater effort among