Birth As an American Rite of Passage

Cover
Half Title
Series Page
Title Page
Copyright Page
Dedication
Table of Contents
List of Illustrations
About the Author
Author’s Note about the Cover Images
Acknowledgments
Preface to the Third Edition
Introduction: Birth as a Rite of Passage
	Research Methods and Theoretical Issues
	A Brief Overview of This Book
Chapter 1 Ritual and Rite
	The Characteristics and Effects of Ritual
		Symbolism
		A Cognitive Matrix
		Repetition, Rhythm, and Redundancy: Ritual Drivers
		Ritual Tools, Techniques, and Technologies
		Ritual Frames
		Order, Formality, and a Sense of Inevitability
		Acting, Stylization, and Staging: Ritual Performance
		Affectivity and Intensification
	The Possible Effects of Ritual
		Cognitive Simplification
		Cognitive Stabilization and Fear Reduction
		Cognitive Transformation
		Preservation of the Status Quo
		Effecting Social Change
		Rites of Passage
Chapter 2 The Stages of Matrescence: The Pregnancy/Childbirth/Postpartum Rite of Passage
	Separation: “Oh My God, I Think I’m Pregnant!”
	Transition: Pregnancy as Transformation
		Transformation in the Personal Domain
		Transformation in the Public Domain
		Transformation in the Medical Domain
		Transformation in the Midwifery Domain
		Transformation in the Formally Educative Domain: Pregnancy as a Quest for Knowledge
		Transformation in the Peer Domain
	Transition: Birth as Transformation
	Transition: The Immediate Postpartum Period
	Integration: “Swimming Up on the Other Side”
Chapter 3 The Industrial and Technocratic Models of Birth and Health Care
	Medicine as a Microcosm of American Society
	The Industrial Model of Birth
		The Body as Machine and the Female Body as a Defective Machine
	The Technocracy
	The Technocratic Model of Birth and Health Care
		The Myth of Technological Transcendence
		The 1–2 Punch and the Technological Imperative
	The 12 Tenets of the Technocratic Model of Birth and Health Care
		(1) Mind-Body Separation and (2) the Body as Machine
		(3) The Patient as Object; and (4) Alienation of Practitioner from Patient
		(5) Diagnosis and Treatment from the Outside In
		(6) Hierarchical Organization and (7) Standardization of Care
		(7) Authority and Responsibility Inherent in Practitioner, Not Patient
		(8) Supervaluation of Science and Technology
		(9) Aggressive Intervention with Emphasis on Short-Term Results, and (10) Death as Defeat
		Technomedical Hegemony: (11) A Profit-Driven System; and (12) Intolerance of Other Modalities
Chapter 4 The Humanistic Model of Birth and Health Care
	The 12 Tenets of the Humanistic Model of Birth and Health Care
		Mind-Body Connection
		The Body as an Organism
		The Patient as Relational Subject
		Connection and Caring between Practitioner and Patient
		Diagnosis and Healing from the Outside In and from the Inside Out
		Balance between the Needs of the Institution and the Individual: Superficial vs. Deep Humanism
		Information, Decision Making, and Responsibility Shared between Patient and Practitioner
		Science and Technology Counterbalanced with Humanism
		Focus on Disease Prevention: A Public Health Approach
		Death as an Acceptable Outcome
		Compassion-Driven Care
		Open-Mindedness toward Other Modalities
Chapter 5 Birth Messages in the Hospital
	A Symbolic Analysis of Standard Obstetric Procedures
		Technocratic Rituals and Humanistic Ritual Changes
		The Wheelchair
	The “Prep”
		Replacement of Clothes with Hospital Gown
		Pubic Shaving and Enemas: Humanistic Ritual Change
		Separation from Partner and Other Support People during the Prep
		The Presence of a Doula: Humanistic Ritual Change
		Fasting
		Ritual Purposes
		Intravenous Feeding (IV)
		Artificial Rupture of the Membranes (Amniotomy)
		The “Pit Drip”
	Friedman’s Curve vs. Zhang’s Curve: Humanistic Ritual Change?
	An Argument for a Re-Classification of the “Three Stages of Labor”
	Types of Obstetric Analgesia
		Epidurals, Demerol, Fentanyl, Stadol, Morphine, and Nitrous Oxide
		Cervical Checks
		External Electronic Fetal Monitor and Tocometer
		Internal Electronic Fetal Monitor
		Bed and the Lithotomy and Semi-Sitting Positions for Labor and Birth
	The Influence of Labor and Delivery Nurses: A Brief Note
	You’re 10 Centimeters: Now Push!/ Don’t Push!
	The Labor-Delivery-Recovery Room: Humanistic Ritual Change
	Water Immersion during Labor: Humanistic Ritual Change
		Episiotomy: Humanistic Ritual Change
		Cesarean Births and Vaginal Births after Cesarean (VBACs)
		Maintaining the Same Cesarean Rate Despite Attempts to Lower It: Techno-Maternity Care as a Self-Organizing, Self-Stabilizing System?
		Apgar Scoring
		Umbilical Cord Clamping and Cutting
		(Not) Washing the Newborn
		Prophylactic Eye Treatment
		Vitamin K Injection
		Humanistic Ritual Change: Keeping Mother and Baby Together, and Bonding
	The Hospital Bassinet as Cultural Symbol
	Breastfeeding: Humanistic Ritual Change
	Wheelchair
	From Nature to Culture
		The Obstetric Re-Structuring of Accidental Out-of-Hospital Births
	Summary: Birth Rituals and Society
	The Alternative Birth Center in the Hospital
		A Humanistic Middle Ground?
Chapter 6 How The Messages Are Received: The Spectrum of Response
	Full Acceptance of the Technocratic Model of Birth
		Full Acceptance of the Technocratic Model of Birth: Rejecting Biology in Favor of Technology (9%)
		Full Acceptance of the Technocratic Model of Birth: Entering the Hospital with No Expectations (9%)
		Full Acceptance of the Technocratic Model of Birth: Women on Medicaid Who Had “No Choice” (6%) and the Racialized Maltreatment of Marginalized Women
		Comparative Analysis. Full Acceptance of the Technocratic Model of Birth: “Rejecting Biology in Favor of Technology,” “Entering the Hospital with No Expectations,” and “No Choice for Marginalized Women” (24%)
	Conceptual Fusion with the Technocratic Model during Labor and Birth
		Conceptual Fusion with the Technocratic Model: With Cognitive Ease (40%)
		Conceptual Fusion with the Technocratic Model: With Cognitive Dissonance (15%)
		Comparative Analysis. Conceptual Fusion with the Technocratic Model, with Cognitive Ease vs. with Cognitive Dissonance (55%)
	Maintaining Conceptual Distance from the Technocratic Model via Humanism in Birth (21%)
		Maintaining Conceptual Distance from the Technocratic Model: Counterbalancing Technology with Humanism to Achieve One’s Own Choices (8%)
		Maintaining Conceptual Distance from the Technocratic Model: Achieving Humanized Childbirth in the Hospital with Obstetricians as Primary Birth Attendants (5%)
		Maintaining Conceptual Distance from the Technocratic Model: Achieving Natural Childbirth in the Hospital with Midwives as Primary Attendants (8%)
		Comparative Analysis: Maintaining Conceptual Distance from the Technocratic Model via Humanism in Birth
	A Note on Hospital Birth with Certified Nurse-Midwives (CNMs)
	The Spectrum of Women’s Conceptual Responses to Their Birth Experiences
	The National Scene: “Listening to Mothers III”
Chapter 7 Scars into Stars: The Reinterpretation of the Childbirth Experience
	Compartmentalization
	“Further Epistemic Exploration”: “Teilhard de Chardin” versus “Sartre”
		“Further Epistemic Exploration” through Narrative
		“Further Epistemic Exploration” through Subsequent Births
		“Further Epistemic Exploration” through Subsequent Births and through Involvement with Childbirth
	Scars into Stars: A Brief Note on Hospital Birth Attendants’ Reinterpretations of Their Birth Attendance Experiences
Chapter 8 The Holistic Model of Birth and Health Care
	The 12 Tenets of the Holistic Model
		Oneness of BodyMindSpirit
		The Body as an Energy System Interlinked with Other Energy Systems
		Healing the Whole Person in Whole Life Context
		Essential Unity of Practitioner and Client
		Diagnosis and Healing from the Inside Out
		Individualization of Care
		Authority and Responsibility Inherent in the Individual
		Science and Technology Placed at the Service of the Individual
		A Long-Term Focus on Creating and Maintaining Health and Well-Being
		Death as a Step in a Process
		Healing as the Focus
		Embrace of Multiple Healing Modalities
	Stratification in Holism and Technomedicine
		The Limitations of a Focus on the Individual
	Functional Medicine: A Brief Note
Chapter 9 Birth Messages at Home: Homebirth as Holistic Ideology in Action
	The Background and Context of Homebirth in the United States
	Motivations for Choosing Homebirth
		Birth as a Natural Aspect of Womanhood
		Birth as a Spiritual Process of Growth
		Choosing a Homebirth for Pragmatic Reasons
	Similarities among the Homebirth Interlocutors
	Birth Messages at Home: The Rituals of Homebirth
		The Postmodern Midwife
	The Hospital/Technocratic and Homebirth/Midwifery Models of Care Compared
	When Planned Homebirth Requires Hospital Transfer
	Obstetricians Who Support Homebirths
		Why Do Some Obstetricians Support Midwives and Community Birth?
	The Politics of Homebirth Rituals
	Safety: Ideologies and Realities
	Breeches and VBACs at Home and the “Renegade” Midwives Who Attend Them
	Freestanding Birth Centers: A Mediating Ground
Chapter 10 Technocracy in Birth and Life: Some Ritual and Political Implications for the Future
	The Cultural Consensus
		Why Most American Women Accept Technocratic Birth
	Women’s Rites: The Politics of Birth
	The Technocratic Model of Birth: Futuristic Extremes
	Kiri the Cyborg: Human-Technology Co-Evolution
Chapter 11 Holism in Birth and Life: Some Ritual and Political Implications for the Future
	The Need for the Growth of Community Birth
	The Possibility of Creating the World’s Best Knowledge System about Birth
	Holism in Birth and Life: Social Movements and Futuristic Extremes Based on Systems Theory
	The Technocratic Birth, and Birth as the Biodance
		Envisioning the Richness of Diversity
		My Futuristic Visions
Conclusion: Birth as an American Rite of Passage
References
Index