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Books > Medicine > Nursing & ancillary services > Midwifery
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Pushing in Silence - Modernizing Puerto Rico and the Medicalization of Childbirth (Hardcover)
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Pushing in Silence - Modernizing Puerto Rico and the Medicalization of Childbirth (Hardcover)
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As Puerto Rico rapidly industrialized from the late 1940s until the
1970s, the social, political, and economic landscape changed
profoundly. In the realm of heath care, the development of medical
education, new medical technologies, and a new faith in science
radically redefined childbirth and its practice. What had
traditionally been a home-based, family-oriented process, assisted
by women and midwives and "accomplished" by mothers, became a
medicalized, hospital-based procedure, "accomplished" and directed
by biomedical, predominantly male, practitioners, and, ultimately
reconfigured, after the 1980s, into a technocratic model of
childbirth, driven by doctors' fears of malpractice suits and
hospitals' corporate concerns. Pushing in Silence charts the
medicalization of childbirth in Puerto Rico and demonstrates how
biomedicine is culturally constructed within regional and
historical contexts. Prior to 1950, registered midwives on the
island outnumbered registered doctors by two to one, and they
attended well over half of all deliveries. Isabel M. Cordova traces
how, over the next quarter-century, midwifery almost completely
disappeared as state programs led by scientifically trained experts
and organized by bureaucratic institutions restructured and
formalized birthing practices. Only after cesarean rates
skyrocketed in the 1980s and 1990s did midwifery make a modest
return through the practices of five newly trained midwives. This
history, which mirrors similar patterns in the United States and
elsewhere, adds an important new chapter to the development of
medicine and technology in Latin America.
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