Ideology and Institutional Authority

Abstract

Few non-academics would question the assertion that childbirth represents one of the most natural human enterprises, a bridge linking women of all political ideologies and epochs. From the eighteenth through the twentieth centuries, however, many western women experienced childbirth much differently than how most females engaged in it for millennia.¹ Until the mid-seventeenth century, most women did not assume a supine position for the delivery of their children.² Instead, as evidenced by birthing chairs and other apparatuses, most employed the squatting posture favored by midwives, who felt that lying on the back prolonged labor. What prompted the sudden shift to the conditions most frequently encountered — and deemed the ‘natural’ way — by latter-day western women? Clearly, the metamorphosis resulted from the effects of institutional ideology, and birth historians credit Louis XIV of France — whose credo, ‘I am the state,’ crystallized his autocratic propensities — with popularizing the supine position (Cohen and Estner 1983, 158). In effect, the king’s desire to observe the births in his court — the supine posture allowed him to see more — paved the way for the procedural ritual that followed and became so institutionalized as to appear natural. As doctors compelled midwives to yield responsibility for labor and delivery, the practice born of absolute power received technical rationalization: the doctor ‘needed’ to see in order to complete the ‘procedure.’³ In this way, labor transformed from an event in which midwives assisted women in discovering the position most suited for their own unique birthing processes into an intellectualized operation effectively divorced from biological imperatives.