1. REPRODUCTIVE HEALTH AND THE
TECHNOCRATIC MODEL
A Presentation on the Patriarchal Medicalization of
Natural Childbirth
Ruth Barkan

2. PREGNANCY PRE-SCIENTIFIC REVOLUTION IN
THE UNITED STATES
 Historically, most women gave birth at home without medical
intervention. These births were generally attended by a nurse,
older woman, or midwife, who was considered to be very
knowledgeable about the birth process. Birth took place in the
home, and it was considered to be an event for women. It was
a time for female friends and relatives to come into the home
and care for the mother and her household, provide
reassurance, and offer guidance. Birth was not considered to
be a private event, but more of a social one, that created a
strong bond among women.

3. THE SCIENTIFIC REVOLUTION
 The dual nature of birth as both a women’s social and
empowering rite changed as the central theories of society
were changed by the scientific revolution - a period when new
ideas in physics, astronomy, biology, chemistry, human
anatomy and other sciences led to a rejection of religious and
folk based doctrines that had prevailed through the Middle
Ages, and instead laid the foundation of modern science. The
new emphasis on science, empiricism, experimentation, and
mathematical forms of knowledge led to the medicalization of
what had previously been a natural process.

4. MEDICALIZATION
 Medicalization is the process by which human
conditions and problems come to be defined and
treated as medical conditions and problems, and
thus come under the authority of doctors and other
health professionals to study, diagnose, prevent or
treat.
 The process of medicalization can be driven by new
evidence or theories about conditions, or by
developments in social attitudes or economic
considerations, or by the development of new
purported treatments.

5. MEDICALIZATION
 The process of medicalization is often seen only
through its benefits, but it also involves costs, some
of which may not always be clear cut and apparent.
 Medicalization is studied in terms of the role and
power of professions, patients and corporations,
and also for its implications for ordinary people
whose self-identity and life-decisions may depend
on the prevailing concepts of health and illness.
 Once a condition is classed as medical, a medical
model of disability tends to be used rather than a
social model.

6. THE ADVANCE OF THE MEDICAL AND
TECHNOCRATIC MODEL
 Many of America’s most deeply held beliefs, values, norms,
and mores come from the Scientific Revolution and
Enlightenment of the 17th century
 As a result of the switch from organic to mechanical
metaphors that determined the belief system of Western
society, the human body soon came to be seen as a system of
interchangeable gears and workings that could be fixed and/or
replaced.
 As this mechanical model became the new unifying
conceptual factor, the primary responsibility for the human
body, which once belonged to the church, was assigned to the
medical profession – and by proxy – to men.

7. THE ADVANCE OF THE MEDICAL AND
TECHNOCRATIC MODEL
 The problem, of course, is that bodies are not machines. The
core mission, therefore, of Western medicine was to prove the
viability of their model by making bodies appear as
mechanical as possible.
 The paradigm of pregnancy dominant in the medical domain
is the technocratic model, which asserts that:
a. The baby develops mechanically and involuntarily inside
the woman’s womb
b. The (Male) Doctor is in charge of the baby’s proper growth
and development
c. The (Male) Doctor will deliver (produce) the baby on a
scheduled pre-approved date

8. PREGNANCY PRE-SCIENTIFIC REVOLUTION IN
THE UNITED STATES
 In our society, pregnancy has only recently been accepted as
an appropriate event in the public sphere.
 Before WWII, pregnant women were to remain secluded in
their homes, and when in public, their pregnancy was to be
disguised.
 Even the word “pregnant” was too pregnant to be used. A
woman was “expecting”, “in the family way”, “with child”, or
“baking a bun in the oven.”
 These euphemisms helped to mask that it was nature, and not
society, that created new human beings.

9. PATRIARCHY OF THE NEW MODEL
 To continue the male/female power relationship was
to simply declare one body as normal and the other
as deviant:
“So the men who established the idea of the
body as a machine also firmly established the male
body as the prototype of this machine . . . Insofar as
it deviated from the male standard, the female body
. . . due to its unpredictability and its occasional
monstrosities, was itself regarded as inherently
defective and in need of constant manipulation by
man” (Merchant, 1983:2).

10. PATRIARCHY OF THE NEW MODEL
 Moreover, the pregnant women, unlike any other
human being, holds two individuals in one body.
This phenomenon refutes two of society’s most
powerful structural logics – the societal more that
one body contains but one individual, and the
mathematical law that one cannot equal two.

11. Who knew that Kellogg’s Corn Flakes were so good for your ovaries?
Why, men did of course!

12. BIRTH RITUALS AND RESPONSES
 Wheelchair – When a pregnant woman in labor walks into the
hospital, the first thing to happen is that she will be asked or
told to sit in a wheelchair.
 Most women feel that they are perfectly capable of
walking in the first stages of labor, and are no more likely
to fall during labor than when it began.
 To place a healthy women undergoing a natural process in
a wheelchair is to tell her that her body is defective,
disabled, and weak

13. BIRTH RITUALS AND RESPONSES
 The Hospital Gown – The official rationale is that the gown is
cleaner than a woman’s own clothes, and allows for easier
access to the genital area for the birth as well as the back for
the administration of an epidural.
 A woman’s clothes are her markers of individuality –
trading them for a institutional gown effectively
communicates that she is no longer her own person, but
the property of the institution, and therefore, dependent on
the institution.

14. BIRTH RITUALS AND RESPONSES
 The Pitocin Drip – Used to induce or hasten labor, pitocin is a
necessary treatment for any labors that have not started two
weeks after the “due date” or within 24 hours of the membrane
rupturing.
 Under the technocratic model, women’s bodies are seen
as machines which should work on time. By giving petocin,
she is told that her “machine” is not working properly, and
is therefore in need of repair by the institution
 Moreover, the administration of petocin enforces the idea
that the institution’s schedule is more important than that of
her body’s own internal rhythms and individual needs.

15. PRIVATE TO PUBLIC DOMAIN
 As pregnant women entered the public sphere, they
became walking symbols of feminine weakness
(witness the number of men who will open the door
for or give up their bus seat for a pregnant women
vs. a non-pregnant women).
 Pregnant women even have allowed for complete
strangers to reach out and pat their stomach – they
have accepted the societal values that make their
belly part of the public institutional domain, and
therefore, the property of all.

16. PAT THE RABBIT, PAT THE BELLY
http://www.pregnancyetc.com/touching-the-pregnant-belly.htm

17. SO, WHAT HAVE WE LEARNED TODAY, CLASS?
 As social workers working with women of all ages, economic classes, racial or ethnic
groups, sexual orientations, religions, and backgrounds that vary wildly, we will find that
the common thread of women’s health and especially reproductive health, is a key factor
that frames women’s past, present, and future experiences.
 Understanding the unique experience of gender oppression is key to understanding the
experiences that women face when trying to receive adequate health care today.
 As social workers, we need to put our client’s needs before our own – our own ethical
and moral views about issues such as contraception, abortion, sex education, and
motherhood need to be put aside.
 Valuable resources for women do exist out there – they just can sometimes be harder to
find!
 We need to keep in mind alternative methods of dealing with women’s needs that serve
to empower women and find resources for these services as well as those that are more
medicalized.
 Women have been denied control over their bodies for much of our history – as social
workers it is our duty and our privilege to give them that control back by allowing and
supporting them in making their own choices.