Reacting to the Medical Bureaucracy:

Abstract

Lay midwifery resurfaced in the 1970s in the United States largely as a response to the increasing medicalization and bureaucratization of childbirth which began to gain strength after World War II. A minority of increasingly dissatisfied women began to search for birth options. Dissatisfaction centered on birth in the hospital under the supervision and control of a licensed obstetrician, with consequent loss of family involvement and personal participation. These women challenged existing norms with the aim of changing hospital policies and physician attitudes, turned to midwifery, or sought maternity clinics in order to experience childbearing as a family event rather than in a physician-dominated medical process. However, the medical bureaucracy constitutes a barrier to change. Consumer demands, insurance reform, and research on safety issues have, nonetheless, begun to force some changes in hospital policies and have aided the midwifery movement.