MoonDragon's Articles: Technocratic vs. Holistic Models of Birth

MOONDRAGON ARTICLES

The Technocratic & Wholistic Models of Birth Compared

From Birth As An American Rite of Passage Š1992 by Robbie Davis-Floyd
Other excerpts from this book

The Technocratic (Medical) Model of Birth

The Wholistic (Midwifery) Model of Birth

male perspective female perspective
male-centered female-centered
woman = object woman = subject
male body = norm female body = norm
female = defective male female normal in own terms
classifying, separating approach wholistic, integrating approach
mind is above, separate from body mind and body are one
body = machine body = organism
female body = defective machine female body = healthy organism
female reproductive processes dysfunctional female reproductive processes normal, healthy
pregnancy and birth inherently pathological pregnancy and birth inherently healthy
doctor = technician midwife = nurturer
hospital = factory home = nurturing environment
baby = product mother/baby inseparable unit
baby grows itself through mechanical process intimate connection between growthof baby and state of mother
fetus is separate from mother baby and mother are one
safety of fetus pitted against emotional needs of mother safey and emotional needs of mother and baby are the same
best interests of mother and fetus antagonistic good for mother = good for child
supremacy of technology sufficiency of nature
importance of science, things importance of people
institution = significant social unit family = essential social unit
action based on facts, measurements action based on body knowledge and intuition
only technical knowledge is valued experiential and emotional knowledge valued as highly as or more than technical knowledge
appropriate prenatal care is objective, scientific best prenatal care stresses subjective empathy, caring
health of baby during pregnancy insured through drugs, tests, techniques health of baby insured through physical and emotional health of mother, attunement to baby
labor = mechanical process labor = a flow of experience
uterus = an involuntary muscle uterus = responsive part of whole
time is important; adherence to time charts during labor is essential for safety time is irrelevant; the flow of a woman's experience is important
birth must happen within 26 hours labors can be short or can take several days
once labor begins, it should progress steadily; if it doesn't, intervention necessary labor can stop and start, follow its own rhythms of speeding up and slowing down
some medical intervention necessary in all births facilitation (proper food, effective positioning, support) is appropriate, medical intervention usually inappropriate
environmental ambience is not relevant environmental ambience is the key to safe birth
woman in bed hooked up to machines with frequent exams by staff is appropriate woman doing what she feels like - movement, sexual play, eating, sleeping - is appropriate
labor pain is problematic, unacceptable labor pain is acceptable, normal
analgesia and anesthesia for pain during labor mind/body integration, labor support for pain
iatrogenic (doctor-caused) pain is acceptable practitioner must strive not to cause pain to the woman
once a Cesarean, always a Cesarean for many women; VBAC high risk vaginal birth after Cesarean (VBAC) low risk, normal
unusual presentations, such as breech, require severe intervention, usually Cesarean midwifery techniques for unusual presentations - e.g., external version or delivery on hands and knees for breech
birth = a service medicine owns and supplies to society birth = an activity a woman does that brings new life
obstetrician = supervisor/manager/skilled technician midwife = skillful guide
the doctor controls the midwife supports, assists
responsibility is the doctor's responsibility is the mother's
the doctor delivers the baby the mother births her baby

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The Technocratic (Medical) Model of Birth	The Wholistic (Midwifery) Model of Birth
male perspective	female perspective
male-centered	female-centered
woman = object	woman = subject
male body = norm	female body = norm
female = defective male	female normal in own terms
classifying, separating approach	wholistic, integrating approach
mind is above, separate from body	mind and body are one
body = machine	body = organism
female body = defective machine	female body = healthy organism
female reproductive processes dysfunctional	female reproductive processes normal, healthy
pregnancy and birth inherently pathological	pregnancy and birth inherently healthy
doctor = technician	midwife = nurturer
hospital = factory	home = nurturing environment
baby = product	mother/baby inseparable unit
baby grows itself through mechanical process	intimate connection between growthof baby and state of mother
fetus is separate from mother	baby and mother are one
safety of fetus pitted against emotional needs of mother	safey and emotional needs of mother and baby are the same
best interests of mother and fetus antagonistic	good for mother = good for child
supremacy of technology	sufficiency of nature
importance of science, things	importance of people
institution = significant social unit	family = essential social unit
action based on facts, measurements	action based on body knowledge and intuition
only technical knowledge is valued	experiential and emotional knowledge valued as highly as or more than technical knowledge
appropriate prenatal care is objective, scientific	best prenatal care stresses subjective empathy, caring
health of baby during pregnancy insured through drugs, tests, techniques	health of baby insured through physical and emotional health of mother, attunement to baby
labor = mechanical process	labor = a flow of experience
uterus = an involuntary muscle	uterus = responsive part of whole
time is important; adherence to time charts during labor is essential for safety	time is irrelevant; the flow of a woman's experience is important
birth must happen within 26 hours	labors can be short or can take several days
once labor begins, it should progress steadily; if it doesn't, intervention necessary	labor can stop and start, follow its own rhythms of speeding up and slowing down
some medical intervention necessary in all births	facilitation (proper food, effective positioning, support) is appropriate, medical intervention usually inappropriate
environmental ambience is not relevant	environmental ambience is the key to safe birth
woman in bed hooked up to machines with frequent exams by staff is appropriate	woman doing what she feels like - movement, sexual play, eating, sleeping - is appropriate
labor pain is problematic, unacceptable	labor pain is acceptable, normal
analgesia and anesthesia for pain during labor	mind/body integration, labor support for pain
iatrogenic (doctor-caused) pain is acceptable	practitioner must strive not to cause pain to the woman
once a Cesarean, always a Cesarean for many women; VBAC high risk	vaginal birth after Cesarean (VBAC) low risk, normal
unusual presentations, such as breech, require severe intervention, usually Cesarean	midwifery techniques for unusual presentations - e.g., external version or delivery on hands and knees for breech
birth = a service medicine owns and supplies to society	birth = an activity a woman does that brings new life
obstetrician = supervisor/manager/skilled technician	midwife = skillful guide
the doctor controls	the midwife supports, assists
responsibility is the doctor's	responsibility is the mother's
the doctor delivers the baby	the mother births her baby