The term medicalization is not shy in the healthcare field, as its overuse has come to dominate aspects of women’s daily lives, such as pregnancy and childbirth. Overmedicalization, or excessive medical treatment during pregnancy and childbirth continues to be used as a tool to make women lose control over their bodies. Examining the medical model of motherhood, many argue that women have the right to make informed medical decisions when considering their bodies. However, the idea that women possess the capacity to have a choice in their own medical decisions is a false reality as we disregard them as these passive recipients in healthcare. This form of neglect toward the identity and anatomy of women’s bodies not only alters and interferes with the previously considered natural experience of pregnancy and childbirth, but also implicates women’s view of their own bodies, and their roles as mothers[3].
Women: The Passive Recipients of Healthcare
While medicalization has transformed the once natural process of childbirth and pregnancy into a medical event, this has led to the loss of control and agency for women. Overmedicalization can also reinforce traditional gender roles by positioning women as passive recipients of medical care rather than active participants in their own health and well-being. It can lead to a lack of trust between the patient and their healthcare provider, as the provider may be seen as the expert, and the patient may feel powerless to make decisions for themselves. This issue can result in a lack of informed consent and autonomy in decision-making as we brush aside women’s feelings and have others decide for them[1].
The medicalization of pregnancy and childbirth can also lead to a decreased sense of control and autonomy for women during their pregnancy and childbirth. Women may feel pressured to comply with medical recommendations rather than make their own informed decisions[2]. For instance, a woman may be told by her doctor that she needs to have a cesarean section for reasons she does not fully understand and may feel like she has no other option but to comply with the recommendation[1]. This may lead to feelings of anxiety, trauma, helplessness, and a sense of disconnection from the process before and after giving birth.
Reproduction as a Social Control
Has the overmedicalization of pregnancy and childbirth become a social control?
“The most powerful emperical stimulus for this realization of how much everyone has or believes he has something organically wrong with him, or more positively put, how much can be done to make one feel, look, or function better[4].”
Irving Kenneth Zola in Medicine as an Institution of Social Control
Overmedicalizing pregnancy and childbirth has become a social control as there is an expectation that women are to conform to medical norms and standards. Rather than being allowed to make their own choices about bodies, the reliance on medical professionals to make decisions about their bodies continues to perpetuate a form social control over women[3].
In general, medicalization has become a tool used to exert social control over women’s bodies during both pregnancy and childbirth as it goes way beyond what is necessary to treat or prevent illness. Pregnancy for example has been medicalized to an unnecessary degree, with routine procedures and interventions that may not be necessary for all women. Prenatal care has become increasingly routine, with frequent ultrasounds, blood tests, and other procedures that can be expensive and time-consuming[4]. More specifically, the routine use of fetal monitors during labor. Fetal monitors were introduced in the 1970s to detect and prevent fetal distress, but they have become a routine part of the labor process, even for women who are not at high risk[4]. Moreover, fetal monitors have not been shown to improve the outcomes for low-risk pregnancies. Alongside many others, fetal monitors fall under the category of unnecessary procedures performed that may potentially lead to risks and complications for both mother and baby[3].
Increase in Medical Interventions
“According to the Listening to Mothers in California survey, 74% of California mothers agreed that childbirth should not be interfered with unless medically necessary, but only 5% gave birth with no major medical intervention.[1]“
Listening to Mothers in California, “Infographic: The Overmedicalization of Childbirth.”
While statistically speaking, according to Listening to Mothers in California, 74%, or rather the majority of expecting mothers preferred to have an absence of any interference during childbirth[1]. Yet, only 5% gave birth without any medical interferences – what are possible factors that contribute to these drastic statistics, and what are the alternatives[1]?
Pregnancy and childbirth are natural experiences, but overmedicalization can make them seem like medical conditions that require constant monitoring and intervention[2]. Medical interventions during pregnancy and childbirth are often driven by the desire for control and profit rather than medical necessity. These interventions can increase the risk of complications and interfere with the natural birthing process, which can be traumatizing for the mother and the baby. Induction is perhaps considered an intervention, often used to prevent complications. Epidurals and cesarean sections are other procedures increasingly used that are not always necessary[2]. Using an episiotomy, a surgical incision made in the perineum during childbirth to widen the vaginal opening is another medical procedure that isn’t always necessary. The routine use of episiotomies has been debunked as unnecessary by research, yet the procedure is still performed routinely in many hospitals[2].
While medical interventions are necessary in some cases, there are alternatives to the overuse of medical technologies for pregnancy and childbirth. One alternative is the use of midwifery care, which emphasizes a holistic, patient-centered approach to pregnancy and childbirth. Midwifery care has been shown to be associated with improved maternal and infant health outcomes, as well as higher rates of patient satisfaction[5]. Education is also an important alternative to medicalization. Women who are well-informed about the risks and benefits of medical interventions are more likely to make informed decisions about their healthcare. Education can also help to reduce fear and anxiety about pregnancy and childbirth, which can lead to a more positive experience overall.
Looking at the Bigger Picture
Like many young women, I have grown up watching movies, reading stories, seeing social media posts and television ads that feature the joys and beautiful moments of pregnancy and childbirth. The messages are usually very uplifting and focuses on the emotional part of reproduction. However, there is another side of pregnancy and childbirth that is rarely discussed or featured in news articles on overmedicalization, and other limitations within the health system for women during childbirth. While I have not experienced childbirth, and hope to have a family in the future, I am much more aware of potential limitations and challenges that I may face when I navigate my own pregnancy or childbirth. Growing up, I was taught to fight for personal choices and value my ability to make my own health care decisions. It is imperative that all women choosing to bear children and enter motherhood have the ability to navigate their own health care options. While society tends to highlight the joys of pregnancy, there needs to be more open discussions on the limitations, potential interventions and overmedicalization of childbirth so women can make informed decisions about their own health care.
It is important to recognize that the phenomenon of overmedicalization is not limited to pregnancy and childbirth. Overmedicalization can also occur in other areas of healthcare, such as the management of menopause or the treatment of mental health disorders[5]. Overmedicalization of women’s pregnancy and childbirth can have significant consequences for both the mother and the child. It is essential to balance medical interventions with respect for women’s autonomy and agency in making informed decisions about their bodies and health. On the one hand, medicalization can lead to an increased understanding of the medical aspects of pregnancy and childbirth, as well as increased safety and access to care. On the other hand, it can lead to a lack of autonomy and respect for traditional birthing practices, as well as increased risks and complications[2]. It is essential for healthcare providers to be aware of these impacts and to ensure that women are informed and empowered throughout the birthing process.
References
[1]“Infographic: The Overmedicalization of Childbirth.” California Health Care Foundation, August 21, 2019. https://www.chcf.org/publication/infographic-overmedicalization-childbirth/#related-links-and-downloads.
[2]Martin, Emily. “Medical Metaphors of Women’s Bodies: Menstruation and Menopause – JSTOR.” Accessed February 20, 2023. https://www.jstor.org/stable/45130557.
[3]“Medicalization, Social Control, and the Relief of Suffering.” Accessed February 20, 2023. https://onlinelibrary.wiley.com/doi/10.1002/9781444314786.ch10.
[4]“Medicine as an Institution of Social Control – Irving Kenneth Zola, 1972.” Accessed February 20, 2023. https://journals.sagepub.com/doi/abs/10.1111/j.1467-954X.1972.tb00220.x.
[5]“Women Have Been Misled about Menopause.” NYT inEducation. Accessed February 20, 2023. https://nytimesineducation.com/women-have-been-misled-about-menopause/.