Parenting Excerpts

The following article is an excerpt from Ina May’s Guide To Childbirth by Ina May Gaskin, published by Bantam Books, reprinted with permission from Bantam Books.

The Two Models of Maternity Care
It is important to know that there are two distinct ways of thinking about pregnancy and birth in the United States, as well as in many other countries. Out of these very different conceptions of women’s bodies and the meaning of birth have come two separate models of maternity care: the midwifery or humanistic model of care and the techno-medical model of care.

The midwifery model of care is female-centered. Within it, birth is something that women do – not something that happens to them. The birth-giving woman is the central agent in the ancient drama of life bringing forth new life. The midwifery model of care recognizes the essential oneness of mind and body and the power of women in the creation of new life. The midwifery model of care conceives of pregnancy and birth as inherently healthy processes and of each mother and baby as an inseparable unit. The emotions of the woman have a very real impact on the well being of the baby. When the woman’s emotional needs are filled, there is less risk for the baby. The reality is that the baby has no choice but to feel what the mother feels. Prenatal visits within the midwifery model tend to be much longer. The midwifery model…recognizes the importance of good nutrition as the best way to prevent most complications of pregnancy. It emphasizes the importance of companionship and encouragement during labor as a way to minimize technological intervention in the birth process. It does not impose arbitrary time limits in physiological processes.

The techno-medical model of maternity care…is relatively new on the world scene, having existed barely two centuries. This male-derived framework for care is a product of the industrial revolution. Pregnancy and labor are seen as illnesses, which, in order not to be harmful to mother or baby, must be treated with drugs and medical equipment. Within the techno-medical model of birth, some medical intervention is considered necessary for every birth…and once labor starts, birth must take place within twenty-four hours.

Mind and body are considered to be separate within the techno-medical model of birth. Women who give birth vaginally generally labor in bed hooked up to electronic fetal monitors, intravenous tubes and pressure-reading devices. Eating and drinking in labor are usually not permitted. Labor pain within this model is seen as unacceptable, so analgesia and anesthesia are encouraged. Episiotomies are routinely performed, out of a belief that birth over an intact perineum…might be harmful to mother or baby. Instead of being the central actor of the birth drama, the woman becomes a passive, almost inert object – representing a barrier to the baby’s eventual passage to the outside world.

Ina May’s Guide to Childbirth is available for purchase in the Books and Music section:

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