MOONDRAGON ARTICLES
The Technocratic & Wholistic Models of Birth Compared
From Birth As An American Rite of Passage ©1992 by Robbie Davis-Floyd
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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