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The Growth of Medical Authority: Technology and Morals in Turn‐of‐the‐Century Obstetrics
Author(s) -
Leavitt Judith Walzer
Publication year - 1987
Publication title -
medical anthropology quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.855
H-Index - 55
eISSN - 1548-1387
pISSN - 0745-5194
DOI - 10.1525/maq.1987.1.3.02a00020
Subject(s) - cephalopelvic disproportion , psychological intervention , control (management) , medicine , nursing , public relations , obstetrics , sociology , political science , pregnancy , management , economics , genetics , caesarean section , biology
Before 1880 birthing women and their female attendants dominated decisions concerning labor and delivery. Between about 1880 and 1920, however, the medical profession gained control of obstetrical care, and birth increasingly took place within hospitals. Using the specific example of the debate about performing craniotomies (the surgical mutilation of the fetal head to permit vaginal extraction) on live fetuses, the paper analyzes how technological innovations, changing medical theory, moral and ethical considerations, and professional interests interacted to make physicians more powerful arbiters in America's birthing rooms. Decisions surrounding cases of cephalopelvic disproportion, when major surgical interventions became essential, reveal most starkly the issue of control. Physicians learned to use such situations to increase the importance of what they felt was the uniquely scientific basis of their own contribution. The establishment of physicians' authority over emergency home‐based deliveries in this turn‐of‐the‐century period was a necessary prerequisite to their ultimate assumption of hospital‐based authority.