Birthing Centers and Hospices: Reclaiming Birth and Death

Environments, People, and Health

“…In the United States only two generations ago, most people gave birth at home and died at home, most often in the bosoms of their families. Today in the United States, 95% of births take place in hospitals and over 70% of deaths take place in nursing homes and hospitals (150). The locating of birth and death in hospital environments has removed them from the realm of fa mily responsibility and generational knowledge and has identifi ed them as patho logical functions.…”

Mental health and public health: Strengthening a working relationship

“…Thus, their health is reflective of social arrangements. For example, the hierarchical distribution of goods, money, power and status is usually inversely correlated with health (Lindheim andSyme, 1983, Nagi andStockwell, 1973;Kitagawa and Hauser, 1973). The association of social class and mental illness must be understood, at least in part, in these terms.…”

“…These settings are characterized by: 1) concern with a restricted range of problems; 2) rejection of the notion that serious clinical situations are always best dealt with by large bureaucratic institutions; 3) an orientation and set of procedures that are arrived at jointly by clients, their advocates, and professionals; and 4) an orientation that is "semi-medicalized". Both birthing centers and hospices embody a reaction to the overuse of medical technology, an acknowledgement that a hospital environment may produce iatrogenic effects, an attempt to involve family members in care, and a wider appreciation of the skills of non-medically trained professionals (Lindheim, 1981;Arms, 1975;Chalmers, 1978;Halper, 1979;Stoddard, 1978;Ryder and Ross, 1977).…”

Malpractice Verdicts and Changing Birthing Practices

“…At the same time, the hierarchical arrangement of the labor and delivery support staff minimized potential competition for the provision of childbirth care, because other practitioners, particularly nurses, would not be trained to actually be the birth attendant . In later decades, the division of staff roles during maternity care was reflected in the architecture of hospitals, which were encouraged to have separate spaces for different components of childbirth care . The practice of actively managing labor with oxytocin was introduced in the late 1960s, adding a skill requirement for childbirth care providers and enabling a more predictable course of labor and thus a more efficient use of hospital staff and physician time .…”

“…21 In later decades, the division of staff roles during maternity care was reflected in the architecture of hospitals, which were encouraged to have separate spaces for different components of childbirth care. 22 The practice of actively managing labor with oxytocin was introduced in the late 1960s, adding a skill requirement for childbirth care providers and enabling a more predictable course of labor and thus a more efficient use of hospital staff and physician time. 17,21,23 Currently, nearly half of births in the United States involve some type of intervention to speed up the labor process, thus hastening the time from arrival at the hospital to birth.…”