Times past - times present: The midwife
Lentz, Judith R.
Doctor of Philosophy
Midwifery has re-emerged as a birthing system and women are again seeking midwives as their birth attendants. This pluralization of the U.S. medical system and its birthing system is on one level of interpretation is attributable to some primarily middle class women's and couples' dissatisfaction with hospital maternity care and with physicians' activist attitude and interventionist approach to child birth. The practice of lay or independent midwifery began to emerge in the late 1960's, in conjunction with, and as a response to, these women's demands for unmedicated birth experiences. It is argued that these women's dissatisfactions with medicalized birth and the lay midwife's alternative definition of and approach to birth are expressions of the more generalized dissatisfaction with the institutions of modernity, the materialistic explanation of science, and the rational solutions of technology. Consciously or unconsciously, the women who choose and the lay midwives who attend their alternative births are, by their decisions and actions, joining a larger social discourse which involves not only a rethinking of the efficacy of obstetrics as a total system for doing birth and the deconstruction of the institutions and practice of technological birth but a rethinking of the mechanistic worldview and of the Enlightenment enterprise of reconstructing society to conform with the principles of natural law and social relationships to conform with the theory of complementary gender relationships. The practice of midwifery was progressively taken over by men as the occupations were professionalized; but it was the elimination of the dualism in this society's social roles and interpersonal relationships, that disqualified the midwife as a birth attendant. The re-emergence of the midwife is not only associated with the deconstruction of the mechanistic worldview but the emergence of alternatives to the complementary gender relationships of modernity. The lay midwife's solution is to return to the dualistic roles characteristic of colonial America's traditional medical relationships. The nurse-midwife, by education and experience, works and thinks in such a way that the categories which characterize the particular genders and their respective realm of the caring and curing are harmonized rather than dichotomized.