Medicalization Flashcards
define medicalization
process through which condition or behaviour becomes defined as medical problem requiring medical solution.
- extends medical jurisdiction +authority into broader areas of life.
how does medicine exercise moral + social control
- in life deemed relevant to good practice of medicine
- through retention of absolute control over certain technical procedures
- ## retention of near absolute control in access to human body
life deemed relevant to good practice of medicine:
med has ability to decide what to focus on. if had condition in past, would go to healer/priest. now going to medicine.
- > re-define aging with cosmetic surgery
- > re-define life with prolonging life of brain dead patient
retention of absolute control over certain technical procedures
ie. surgery, prescribe meds.
- > starting to change to certain degree.
retention of near absolute control in access to human body
medicine has authority to touch living + dead. access to inner workings on body.
-> few professions that have access to interior of body
the medicalization of childbirth:
mid-1800’s midwives accepted. experiential knowledge. community-based birth, community event + assistance until mom ready to step into role again.
-> natural, but still risky for some.
end of 20th century: childbirth is medical event no longer same as in past. physician managed.
3 ways medicine was successful in gaining control over childbirth
- deemed it relevant to good practice of medicine.
- through retention of absolute control over certain technical procedures
- through retention of near absolute control in access to human body
how deeming relevance to medicine = control over childbirth
science was trusted, science portrayed cb as risky event.
midwives depicted as dangerous, untrained (wisdom, experience > science)
retention of absolute control over technical procedures - childbirth
medical forceps used in cildbirth, help to pull child out = ended up crushing skulls..
science said this was good, even tho midwives had safer births.
retention of control over access to human body = childbirth
medical schools to train in childbirth procedures.
childbirth unsuitable for Victorian woman.
science + innovation taught how to access body for childbirth - c-section.
two ways progression of medicalization of childbirth has occured.
- relocation of childbirth from home to hospital
2. labour increasingly viewed as condition that requires medical surveillance + intervention
relocation of childbirth
majority at home 1930s -> nearly 100% in hospital by 1960.
why was there a transition from home to hospital?
both doctors + women saw is as desirable.
- > doc: practice new skillls to make birth more comfy + safe. (eliminate risk, clinical, sterile enviro.
- > women provide practical service and place to recuperate ( consequence: no longer had community support; hopital disengaging, week to recuperate - rest from routine
did transitio produce desired effect?
no. doctors did not completely reduce risk. still risk for some.
- women felt alienated. no control over birthing process
labour viewed as condition that needs medical surveillance + intervention
do more = manage risk = better outcome
EF (fetal monitor)
Friedman curve
episiotomies
EFM - what is it?
relate to medical model approach? when was it made?
rate of use in 90’s? in 2006?
fetal monitor. correlates fetal heart rate with strength + periodicity of uterine contractions. (mind-body dualism: doesnt matter what she says, output on screen is more important) might show fetus in distress
in 1960’s; meant for high-risk pregnancy. by 1990’s 80% of women monitored. 2006 91% of births used EFM
problems with EFM
no evidence that improves outcomes for newborn or mother.
- > increase c-section. no long-term benefits for baby.
- > screening in high prevalence is best. rare condition - screening = false positives.
c-section births rates?
not causal relationship with EFM, but deff saw increase in c-sections over time. now 1/5 have c-section
countries + c-section rates.
2015 - 21% of all births.
-> worldwide c-sections are on the rise. alienating experience: event fully controlled by physicians
friedman curve
- what is it?
- medical model?
- consequence?
defines average length of time for each stage of delivery. body as machine = expect everyone to have same birthing process.
-> taking longer? drugs + c-section.
medically induced births increasing.
-> 45% of women with vaginal birth were induced
episiotomies - what is it?
- rates?
incision of vaginal opening.
once thought that spontaneous tear does more damage, now found that episiotomies do more damage than natural tears.
- peak in 19990 - 49%, 2007 - 17%
summing up medicalization of childbirth:
too little too late or too much too soon.
TMTS = over-medicalization. non-evidence based interventions. disrespect + abuse.
TLTL: social + health inequalities = inadequate care.
both can be in one coutry
