A ship upon a stormy sea: The medicalization of pregnancy

“Scholars have explored hyperactivity (Conrad, 1975), alcoholism (Blaxter, 1978), menstruation (Smith-Rosenberg & Rosenberg, 1973; Vertinsky, 1994), pregnancy (Barker, 1998), sexuality (Tiefer, 1996), obesity (Jutel, 2008), andropause (Conrad, 2007), adult ADHD (Conrad, 1979), and even compulsive buying (Lee & Mysyk, 2…”

“With the development of technology such as ultrasound scans, the medical professionals are now able to see the fetus, and the major concern is the size, condition and the position of the baby or the physiology of pregnancy, among other things (Oakley, 1980, 1984; Barker, 1998; Tautz et al., 2000).”

“Monitoring and medical management of pregnant women has lowered the incidence of many medical complications (Barker, 1998; Oakley, 1984).”

“…have noted, the prenatal period is increasingly defined as an appropriate subject for medical supervision in the US (Abel and Browner 1998, Armstrong 2003, Barker 1998, Browner and Press 1996, Georges and Mitchell 2000, Markens et al. 1997, McNeil and Litt 1992, Oaks 2001, Root and Browner 2001).”

“While prenatal care was promoted as the answer to infant mortality in the early part of the twentieth century (Skocpol 1992), statistical analyses revealed that twentieth-century improvements in maternal and infant mortality predated the universal utilization of clinical prenatal care (Barker 1998).”

“There was limited evidence on pregnant women’s weight-related attitudes and beliefs, however literature on self-identity and body image during pregnancy, socio-cultural representations of the female body, risk and responsibilities during pregnancy, and the medicalisation of pregnancy were plentiful [24,38-45].”

“In short, both arguments highlight that forms of medical social control took place before medicalized societies had been consolidated [e.g., the medicalization of prenatal care is said to have only taken place in the US in 1935, see Barker (1998)].”

“Larsson (2009) and Declercq et al. (2006) also offered some insight into pregnant women’s Internet usage, but unlike Lagan et al. (2010), both Larsson (2009) and Declercq et al. (2006) only looked at usage reporting for pregnancy information and did not include pregnancy-related social networking and support in forums.”

“Therefore, since women consider pregnancy and childbirth as health-related complications, their expectations and attitudes would change significantly (29).”

“Medical knowledge(s) and advice The biomedical discourse has also proceeded to dominate the self-help literature on pregnancy and childbirth (Houvouras, 2006; Marshall & Woollett, 2000; Stapleton, Kirkham, & Thomas, 2002) with increased medicalization now manifest mostly in advice to women on diet and lifestyle (Gross…”

“22 Similarly, scholars have analyzed the declaration of obesity as a “disease” by medical associations as an example in which medical authorities deem a behavioral outcome as a pathology that in turn shifts the focus of interventions from primary prevention at the macro and meso levels of society…”

“Western cultures often treat pregnancy as an illness where pregnant women are expected to take on the sick role and birthing takes place in hospitals, which are institutions for treating illnesses (Barker, 1998).”

“I showed that obstetrics and midwifery are not respectively monolithic fields, each determined by its own philosophy, its own body of knowledge, and its own way of engaging with pregnancies and births (Rooks 1999:370; Davis-Floyd 2018:323–38), despite what the German Association for Midwives and the sociocultural stra…”

“…and birth, and in their preferred models of care (Haertsch, Campbell, & SansonFisher, 1996; Hirst, 2005; Matthias, 2010); these are often described as midwifery and medical models of care (for a discussion of how the discourse of pregnancy is reframed to focus on risk, see also Barker, 1998).”

“While previous research has examined the medicalization of pregnancy and prenatal care (Barker 1998; Shaw 2013), this content analysis provides evidence of the medicalization of the pre-pregnancy period.”

“Unfortunately, because there were few skilled practitioners it resulted in anesthesia-related deaths [5–7].”

“Numerous scholars have documented the historical development of the medicalization of pregnancy and childbirth (e.g., Barker, 1998; Oakley, 1980; Oakley, 1984).”

“Originating with Descartes’ concept of mind–body dualism (Cahill, 2001), the medical model gained momentum during the 20th century when birth was transformed from a normal life event to what was considered a medically problematic crisis (Barker, 1998; Oakley, 1980).”

“To the extent that it was subsumed by medicine under the auspices of ‘‘prenatal and postnatal care,’’ maternal education became in essence another form of medical intervention—extremely difficult to distinguish empirically from other coincident sources of infant care wisdom, such as grandmothers, books, and popular ma…”

“Similar studies document medicalization in medicine of the body, where researchers explore life experiences, such as menopause (Bell 2002), pregnancy (Barker 1998), and aging (Zola 1991), and sexual conditions, like impotence (Tiefer 1984).”

“The 5 steps of a scoping review were followed: (1) Identifying the research question; (2) Identifying relevant studies; (3) Inclusion and exclusion criteria; (4) Charting the data; and (5) Collating, summarizing and reporting the results.”

“3) Other 66 (15) 28 (13) 94 (14) White 291 (65) 159 (73) 450 (68) Ethnicity, n (%) Hispanic or Latino 50 (11) 18 (8) 68 (10) Hollingshead Index of Social Positiona mean ± SD (range) 3.”

“…northern European countries, such as the Netherlands, the “ physiological model ” of assistance without obstetric intervention is on the rise (Akrich, 1996), the medi-calization of childbirth and women's preference for the assistance of doctors rather than midwives remains prevalent (Barker, 1998).”

“Associated with the positioning of pregnant bodies as at risk is the medical surveillance of women throughout gestation, entailing frequent contact with health professionals and technological interventions (see Barker, 1998; Oakley, 1984).”

“This “biomedical privileging” of postpartum depression contributes to what has been lamented as the medicalization of women’s mental health (Cahill, 2001) and the medicalization of pregnancy (Barker, 1998).”

“Some scholars have demonstrated the relevance to pregnancy of concepts often discussed in reproductive or parenting culture studies such as risk, medicalisation and surveillance (Barker, 1998; Lee et al., 2014a; Lupton, 1999; Ruhl, 1999; Weir, 2006).”

“18,19 The United States has a long history of midwifery, including care provided by Black “grand midwives” from the 1600s to the mid-20th century.”

“Similarly, the issue of medicalization of pregnancy has been debated for years [27].”

“Furthermore, medicalization has altered the individuals’ perceptions of the professional skills of midwives, and in this regard, obstetricians have replaced midwives in normal deliveries (7).”

“Historically the medicalization of pregnancy occurred within the 20th century and large changes in how pregnancy was medically represented changed over a short period (Barker, 1998).”

“Sociological and anthropological literatures (Barker, 1998; Lazarus, 1994) emphasise how criticism towards birth technologies remains uncommon.”

“Barker (1998) presented a more socially constructed view of this shift and described the development of childbirth as a “medical problem” to facilitate the movement to the physician’s hospital care.”

“The processes of being pregnant, giving birth and becoming a mother have become increasingly medicalized over the course of the twentieth and early twenty-first centuries (Barker 1998,Ussher 2006>, Gatrell 2008).”

“Programs of antenatal care were first introduced in Europe and the United States during the early decades of the 20th century. These programs, aimed at improving maternal and perinatal outcomes, were mainly directed towards women of underprivileged groups. Gradually, specific procedures to detect defined medical probl…”

“…women has become more sophisticated over time, with technological innovations enabling obstetricians and gynecologists to claim an increasingly detailed knowledge of fetal health and development (Arney 1982; Barker 1998; Burton-Jeangros, Hammer, and Maffi 2014; Fox, Heffernan, and Nicolson 2009).”

“Medical journals and texts are an important source of information for historians, and within feminist research there is a rich tradition of examining such texts to learn more about the medical knowledge circulating during a certain time period (see for instance, Arnup, 1994; Barker, 1998; Vertinsky, 1988; 1994).”

“…managing their own bodily functions.7 The rise of the experts in connection with medicine’s increasing ‘cultural authority’, and the declining authority and confidence of parents have been argued by some commentators as key factors contributing to parental ‘paranoia’ (Barker, 1998; Furedi, 2008).”

“These moments of motherhood-as-medical-condition can be valuable for some mothers and infants (and have even been life saving for an author of this paper), but the expansion can become indiscriminate, so that every moment of every pregnancy becomes scrutinized to the point that the medical ramifications supersede all…”

“The history of pregnancy and childbirth is a long history of the denial of women's experiential and traditional knowledge and replacement by hegemonic obstetrical thinking ( Barker 1998 ; Davis-Floyd 1994 ; Kukla 2005 ; Murphy-Lawless 1998 ; Ruddick 1989 ).”

“Barker argues convincingly that the medical rhetoric used in this and other publications played a significant role in helping to enhance medicine’s cultural authority [16].”

“We can note the presence of a certain paternalism and power relationship in the relationship between healthcare providers and PPs (Barker 1998; Al-Gailani and Davis 2014).”

“gave physicians a key role in controlling the determination of women to abort, this access was subjected to the medicalization (Barker, 1998) of a woman’s body and the management of women’s bodies had become a legitimate object of public policies (Petchesky, 1990).”

“This perception is not uncommon (Elder et al., 2024) and reflects the medicali-zation of pregnancy and the disconnect between scientific definitions and people’s embodied experiences (Barker, 1998; McPhail & Mazur, 2020; Siegel, 2020).”

“Following the growth of medicalisation in the twentieth century (Barker 1998; Conrad 2007), disease constituencies emerged to largely critique the”

“When pregnancy and birth are framed as highly medicalized processes with a strong focus on prevention, interventions, screenings, and monitoring (Chadwick & Foster, 2014), there is the risk for women to feel disempowered and forced to either relinquish their control or to become anxiously involved in opposing the esta…”

“That said, it is important to note that the fall in maternal mortality since the 1950s has not only been linked to increased prenatal care, but also to the elimination of postpartum infection and the improvement in delivery practices (Barker, 1998).”

“Medicalisation is ‘a ship on a stormy sea’, as explained by Barker (1998) with reference to pregnancy and the rise of medicine’s cultural authority in the USA during the twentieth century.”

“Issues like the gender-and class-biased aspects of the “biomedical rhetoric” on pregnancy (Barker, 1998), the discrepancies between the “biomedical discourse” and women’s own experiences in their transition to motherhood (Neiterman, 2013), and the clash between the biomedical definition of…”

“medicine in the USA sought to medicalize pregnancy over the course of the twentieth century and introduce prenatal care as the norm for all pregnant women “through such devices as the host–parasite metaphor” [5].”