Across time and place, pregnancy and childbirth rank among the most
transformative physical and psychological events in women's lives.
Women's childbearing experiences depend not only on their own
biology and psyche but also on the nature and quality of care they
receive. The nature of the prevailing obstetric care model in the
early 21st-century United States has been described as "high-tech,
low touch," highlighting its emphasis on using medical technology,
as opposed to non-technological care and support, to control
unproblematic physical processes on the argument that this approach
improves maternal safety and comfort. However, it should be noted
that reasonably reliable national data fail to show significant
maternal or newborn health gains corresponding to recent, dramatic
rises in hospital obstetric procedures such as labor induction,
labor acceleration, and cesarean delivery. In this context where
medical intervention, necessary or not, assumes an increasingly
central role in the childbearing equation, questions of what
mothers expect to happen in labor and delivery and how their
subsequent birth experiences meet those expectations become
paramount. Global numeric indicators cannot capture the quality of
women's reactions to childbirth itself, particularly as maternal
care shifts in response to consumer interests it presupposes,
offering options for comfort, care, and even the possibility of
foregoing the labor process altogether. This work reflects the
critical need to document early 21st-century U.S. mothers' own
words on what they expected to happen in childbirth and later, how
labor and delivery went and how it met their expectations. Among
this book's most important contributions is its inclusion of
extensive interview material drawn from 75 diverse women who spoke
freely on their childbirth expectations and subsequent experiences.
By itself, the interview material lends an important, though at
times unsettling, insider perspective on how labor and delivery can
unfold. The narratives also provide a maternal view on how those
charged with their care respond during this physically and
emotionally demanding transition. In addition, the book provides a
timely analysis of scientific data on contemporary maternal care
procedures, making plain why so many refer to 21st-century
mainstream obstetric care as "technocratic." The scientific data
serve as an excellent backdrop for more extensive coverage of the
maternal interviews, organized around the distinctions mothers made
related to the childbirth pathway on which they anticipated
traveling such as natural childbirth in a hospital, planned
cesarean delivery, or planned vaginal birth after cesarean. The
pathways are in turn discussed in terms of their relationship to an
underlying technocratic, humanistic, or holistic maternal care
philosophy. The book is targeted towards an academic readership,
including scholars and medical professionals with interest in
women's health, women's and maternal mental health, women's
reproductive health, reproductive technology, medical humanities,
medical anthropology, narrative studies, pregnancy, and childbirth.
General
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