The vanishing mother: Cesarean section and "evidence-based obstetrics"

Med Anthropol Q. 2007 Jun;21(2):218-33. doi: 10.1525/maq.2007.21.2.218.

Abstract

The philosophy of "evidence-based medicine"--basing medical decisions on evidence from randomized controlled trials and other forms of aggregate data rather than on clinical experience or expert opinion--has swept U.S. medical practice in recent years. Obstetricians justify recent increases in the use of cesarean section, and dramatic decreases in vaginal birth following previous cesarean, as evidence-based obstetrical practice. Analysis of pivotal "evidence" supporting cesarean demonstrates that the data are a product of its social milieu: The mother's body disappears from analytical view; images of fetal safety are marketing tools; technology magically wards off the unpredictability and danger of birth. These changes in practice have profound implications for maternal and child health. A feminist project within obstetrics is both feasible and urgently needed as one locus of resistance.

MeSH terms

  • Cesarean Section / statistics & numerical data*
  • Evidence-Based Medicine*
  • Female
  • Humans
  • Longitudinal Studies
  • Mothers*
  • Obstetrics*
  • Practice Patterns, Physicians'
  • Pregnancy
  • United States