This article describes three paradigms of health care that heavily influence contemporary childbirth, most particularly in the west, but increasingly around the world: the technocratic, humanistic, and holistic models of medicine. These models differ fundamentally in their definitions of the body and its relationship to the mind, and thus in the health care approaches they charter. The technocratic model stresses mind-body separation and sees the body as a machine; the humanistic model emphasizes mind-body connection and defines the body as an organism; the holistic model insists on the oneness of body, mind, and spirit and defines the body as an energy field in constant interaction with other energy fields. Based on many years of research into contemporary childbirth, most especially through interviews with physicians, midwives, nurses, and mothers, this article seeks to describe the 12 tenets of each paradigm as they apply to contemporary obstetrical and health care, and to point out their futuristic implications. I suggest that practitioners who combine elements of all three paradigms have a unique opportunity to create the most effective obstetrical system ever known.
As defined by Jordan (1992, 1993[1978]), authoritative knowledge motivates decision and action. Based on interviews with 22 white middle-class midwives in the United States conducted between 1992 and 1993, this article explores the inner knowing that constitutes a primary source of authoritative knowledge for homebirthers but is granted no authority in the realm of technomedicine. The purpose of this article is to call attention to these midwives' utilization of and reliance on intuition as a guide to action and decision making during homebirths. The midwife-interviewees are highly literate and competent in technological skills and biomedical diagnosis, and are keenly aware of the cultural and legal risks they run when they cannot justify their actions during a birth in logical, rational terms. Nevertheless, the deep value they place on connection, in the context of their holistic model of birth and health care, leads them to listen to and follow their "inner voice" during birth, rather than operating only according to protocols and standard parameters for "normal birth". The nature of intuition and the reasons for and consequences of the general devaluation of intuitive thinking by the wider society are also considered.
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