Has the medicalisation of childbirth gone too far?

doi:10.1136/bmj.324.7342.892

BMJ 2002;324:892-895 ( 13 April )

Education and debate

Has the medicalisation of childbirth gone too far?

Richard Johanson, professor of obstetrics ^a, Mary Newburn, head of policy research ^b, Alison Macfarlane, professor of perinatal health ^c.

^a Academic Department of Obstetrics and Gynaecology, North Staffordshire Maternity Hospital, Stoke on Trent ST4 6QG, ^b National Childbirth Trust, Alexandra House, Oldham Terrace, London W3 6NH, ^c Department of Midwifery, St Bartholomew School of Nursing and Midwifery, City University, London EC1A 7QN

Correspondence to: M Newburn m_newburn@national-childbirth-trust.co.uk

The first 150 words of the full text of this article appear below.

Over the past few centuries childbirth has become increasingly influenced by medical technology, and now medical interventionis the norm in most Western countries. Richard Johanson and colleaguesargue here that perhaps normal birth has become too "medicalised"and that higher rates of normal birth are in fact associated withbeliefs about birth, implementation of evidence based practice,and team working

Until the 17th century, birth in most parts of the world was firmly in the exclusively female domestic arena, and hospitalbirth was uncommon before the 20th century, except in a few majorcities. ¹ ² Before the invention of forceps, men had beeninvolved only in difficult deliveries, using destructive instrumentswith the result that babies were invariably not born alive andthe mother too would often die. Instrumental delivery with forcepsbecame the hallmark of the obstetric era. In the 19th and 20thcenturies, medical influence was extended further . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Go bang someone else's drum: Paul Duff
bmj.com, 12 Apr 2002 [Full text]
Medicalizing birth is like putting beauty itself in a cage: Leilah McCracken
bmj.com, 13 Apr 2002 [Full text]
Regional analgesia in labour - a good thing!: William Camann, MD
bmj.com, 13 Apr 2002 [Full text]
Supply and Demand in OB: Robert A Knuppel, et al.
bmj.com, 13 Apr 2002 [Full text]
Fear has no place in childbirth: Stephanie A. Coleman
bmj.com, 14 Apr 2002 [Full text]
Caesarean sections and augmented labours in Greece: Heracles Dellagrammaticas
bmj.com, 14 Apr 2002 [Full text]
Timely intervention is the key.: Meh-Noi Lim, et al.
bmj.com, 15 Apr 2002 [Full text]
Re: Go bang someone else's drum: Sue M. Maguire
bmj.com, 15 Apr 2002 [Full text]
Risks of childbirth medicalisation: Peter W Achterberg
bmj.com, 15 Apr 2002 [Full text]
Informed Consent: Kari E Benson
bmj.com, 16 Apr 2002 [Full text]
Moving with the times: Isidor J Papapetros
bmj.com, 18 Apr 2002 [Full text]
Re. Go bang and moving with the times: Elizabeth M. McAlpine
bmj.com, 21 Apr 2002 [Full text]
Re: Go bang someone else's drum: Cory A. Mermer
bmj.com, 22 Apr 2002 [Full text]
Re: Moving with the times: Marie L Tyndall
bmj.com, 23 Apr 2002 [Full text]
Extinction of endangered normal childbirth in Taiwan - systematic childbirh medicalisation: Peter S Yeh, et al.
bmj.com, 24 Apr 2002 [Full text]
Re: Re. Go bang and moving with the times: Isidor J Papapetros
bmj.com, 24 Apr 2002 [Full text]
Re: Re: Re. Go bang and moving with the times: Charlene Lewis
bmj.com, 30 Apr 2002 [Full text]
Remind safety of childbirth: Josef Wisser
bmj.com, 30 Apr 2002 [Full text]
Objectivity required in the childbirth debate: Felicity Plaat, et al.
bmj.com, 28 May 2002 [Full text]
Is home midwifery-attended home birth a good option?: Gail W. Johnson
bmj.com, 18 Jul 2002 [Full text]
Re: Supply and Demand in OB: Jenny M Hatch
bmj.com, 2 Feb 2003 [Full text]