Improving how individuals give birth and die in the United States
requires reforming the regulatory, reimbursement, and legal
structures that centralize care in hospitals and prevent the growth
of community-based alternatives. In 1900, most Americans gave birth
and died at home, with minimal medical intervention. By contrast,
most Americans today begin and end their lives in hospitals. The
medicalization we now see is due in large part to federal and state
policies that draw patients away from community-based providers,
such as birth centers and hospice care, and toward the most
intensive and costliest kinds of care. But the evidence suggests
that birthing and dying people receive too much-even
harmful-medical intervention. In The Medicalization of Birth and
Death, political scientist Lauren K. Hall describes how and why
birth and death became medicalized events. While hospitalization
provides certain benefits, she acknowledges, it also creates harms,
limiting patient autonomy, driving up costs, and causing a cascade
of interventions, many with serious side effects. Tracing the
regulatory, legal, and financial policies that centralize care
during birth and death, Hall argues that medicalization reduces
competition, stifles innovation, and prevents individuals from
accessing the most appropriate care during their most vulnerable
moments. She also examines the profound implications of
policy-enforced medicalization on informed consent and shows how
medicalization challenges the healthcare community's most
foundational ethical commitments. Drawing on interviews with
medical and nonmedical healthcare providers, as well as surveys of
patients and their families, Hall provides a broad overview of the
costs, benefits, and origins of medicalized birth and death. The
Medicalization of Birth and Death is required reading for
academics, patients, providers, policymakers, and anyone else
interested in how policy shapes healthcare options and limits
patients and providers during life's most profound moments.
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