Birth As an American Rite of Passage

443 Pages·2022·3.24 MB·English

by  Robbie Davis-Floyd, Melissa Cheyney

BIRTH AS AN AMERICAN
RITE OF PASSAGE
This classic book, first published in 1992 and again in 2003, has inspired three
generations of childbearing people, birth activists and researchers, and birth
practitioners—midwives, doulas, nurses, and obstetricians—to take a fresh look
at the “standard procedures” that are routinely used to “manage” American
childbirth. It was the first book to identify these non-evidence-based obstetric
interventions as rituals that enact and transmit the core values of the American
technocracy, thereby answering the pressing question of why these interventions
continue to be performed despite all evidence to the contrary. This third edition
brings together Davis-Floyd’s insights into the intense ritualization of labor and
birth and the technocratic, humanistic, and holistic models of birth with new
data collected in recent years.
Robbie Davis-Floyd, PhD, is an Adjunct Professor in the Department of
Anthropology at Rice University, Houston, Texas, USA, and a Fellow of the Society
for Applied Anthropology. She is a well-known medical/interpretive/reproductive
anthropologist, international speaker, and researcher in transformational models in
childbirth, midwifery, obstetrics, and reproduction.
Social Science Perspectives on Childbirth and Reproduction
Series editor:
Robbie Davis-Floyd, Rice University, Houston, Texas
This series focuses on issues relating to childbirth and reproduction from social
science perspectives. It includes single-authored, co-authored, or edited books
concerned both with people’s reproductive experiences and with birth practi-
tioners such as midwives (both professional and traditional), obstetricians, nurses,
doulas, and others. It seeks to provide new viewpoints on functional and sustain-
able birth models and the challenges to their creation and maintenance, as well as
on obstetric violence, disrespect, and abuse and their root causes. Single-case or
comparative ethnographies on birth and other reproductive issues are featured,
from high-tech conceptions to normal pregnancy and birth, including reproduc-
tive politics and human rights issues in reproduction worldwide.
Birthing Models on the Human Rights Frontier
Speaking Truth to Power
Edited by Betty-Anne Daviss and Robbie Davis-Floyd
Midwives in Mexico
Situated Politics, Politically Situated
Hanna Laako and Georgina Sánchez-Ramírez
Birthing Techno-Sapiens
Human-Technology Co-Evolution and the Future of Reproduction
Edited by Robbie Davis-Floyd
Negotiated Breastfeeding
Holistic Postpartum Care and Embodied Parenting
Caroline Chautems
Birth as an American Rite of Passage
Third Edition
Robbie Davis-Floyd
Doulas in Italy
The Emergence of a New Care Profession
Pamela Pasian
For more information about this series, please visit: https://www .routledge .com
/Social -Science -Perspectives -on -Childbirth -and -Reproduction /book -series /
SSPCR
BIRTH AS AN AMERICAN
RITE OF PASSAGE
Third Edition
Robbie Davis-Floyd
Cover image: Tim Putt
Third edition published 2022
by Routledge
4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
and by Routledge
605 Third Avenue, New York, NY 10158
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2022 Robbie Davis-Floyd
The right of Robbie Davis-Floyd to be identified as author of this
work has been asserted in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or
reproduced or utilised in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
First edition published by University of California Press 1992
Second edition published by University of California Press 2003
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record has been requested for this book
ISBN: 978-0-367-42850-1 (hbk)
ISBN: 978-0-367-43129-7 (pbk)
ISBN: 978-1-003-00139-3 (ebk)
DOI: 10.4324/9781003001393
Typeset in Bembo
by Deanta Global Publishing Services, Chennai, India
I dedicate this book to my precious friend and colleague
Melissa (Missy) Cheyney CPM, PhD, for her many years
of service to birthing families and to midwives, for her
impeccable integrity as a scholar, researcher, and medical
anthropologist, for becoming the national spokesperson for
the value and validity of homebirth, for bravely standing
up to her opponents in that endeavor and their direct
harassments, and for her significant contributions to
midwifery and birth in the United States. Throughout the
writing of this book, I experienced her presence as angel
wings feathered over my shoulders, giving me the strength
and confidence to go on whenever I felt stuck. Missy, I am
forever grateful for your support!

CONTENTS
List of Illustrations xiv
About the Author xv
Author’s Note about the Cover Images xvii
Acknowledgments xviii
Preface to the Third Edition xix
Introduction: Birth as a Rite of Passage 1
Research Methods and Theoretical Issues 2
A Brief Overview of This Book 6
1 Ritual and Rite 8
The Characteristics and Effects of Ritual 8
Symbolism 9
A Cognitive Matrix 10
Repetition, Rhythm, and Redundancy: Ritual Drivers 11
Ritual Tools, Techniques, and Technologies 12
Ritual Frames 12
Order, Formality, and a Sense of Inevitability 13
Acting, Stylization, and Staging: Ritual Performance 14
Affectivity and Intensification 14
The Possible Effects of Ritual 15
Cognitive Simplification 15
Cognitive Stabilization and Fear Reduction 18
Cognitive Transformation 21
viii Contents
Preservation of the Status Quo 22
Effecting Social Change 23
Rites of Passage 23
2 The Stages of Matrescence: The Pregnancy/Childbirth/
Postpartum Rite of Passage 27
Separation: “Oh My God, I Think I’m Pregnant!” 27
Transition: Pregnancy as Transformation 28
Transformation in the Personal Domain 29
Transformation in the Public Domain 32
Transformation in the Medical Domain 37
Transformation in the Midwifery Domain 40
Transformation in the Formally Educative Domain: Pregnancy
as a Quest for Knowledge 41
Transformation in the Peer Domain 45
Transition: Birth as Transformation 49
Transition: The Immediate Postpartum Period 51
Integration: “Swimming Up on the Other Side” 52
3 The Industrial and Technocratic Models of Birth
and Health Care 55
Medicine as a Microcosm of American Society 57
The Industrial Model of Birth 59
The Body as Machine and the Female Body as a Defective
Machine 59
The Technocracy 64
The Technocratic Model of Birth and Health Care 65
The Myth of Technological Transcendence 67
The 1–2 Punch and the Technological Imperative 68
The 12 Tenets of the Technocratic Model of Birth and Health Care 70
(1) Mind-Body Separation and (2) the Body as Machine 70
(3) The Patient as Object; and (4) Alienation of Practitioner
from Patient 70
(5) Diagnosis and Treatment from the Outside In 71
(6) Hierarchical Organization and (7) Standardization of Care 72
(7) Authority and Responsibility Inherent in Practitioner, Not
Patient 73
(8) Supervaluation of Science and Technology 73
(9) Aggressive Intervention with Emphasis on Short-Term
Results, and (10) Death as Defeat 74
Technomedical Hegemony: (11) A Profit-Driven System; and
(12) Intolerance of Other Modalities 75
Contents ix
4 The Humanistic Model of Birth and Health Care 77
The 12 Tenets of the Humanistic Model of Birth and Health Care 78
Mind-Body Connection 78
The Body as an Organism 79
The Patient as Relational Subject 80
Connection and Caring between Practitioner and Patient 81
Diagnosis and Healing from the Outside In and from the
Inside Out 82
Balance between the Needs of the Institution and the
Individual: Superficial vs. Deep Humanism 83
Information, Decision Making, and Responsibility Shared
between Patient and Practitioner 84
Science and Technology Counterbalanced with Humanism 85
Focus on Disease Prevention: A Public Health Approach 85
Death as an Acceptable Outcome 86
Compassion-Driven Care 88
Open-Mindedness toward Other Modalities 89
5 Birth Messages in the Hospital 90
A Symbolic Analysis of Standard Obstetric Procedures 90
Technocratic Rituals and Humanistic Ritual Changes 90
The Wheelchair 92
The “Prep” 93
Replacement of Clothes with Hospital Gown 94
Pubic Shaving and Enemas: Humanistic Ritual Change 95
Separation from Partner and Other Support People
during the Prep 96
The Presence of a Doula: Humanistic Ritual Change 99
Fasting 101
Ritual Purposes 104
Intravenous Feeding (IV) 105
Artificial Rupture of the Membranes (Amniotomy) 108
The “Pit Drip” 109
Friedman’s Curve vs. Zhang’s Curve: Humanistic
Ritual Change? 113
An Argument for a Re-Classification of the “Three Stages
of Labor” 117
Types of Obstetric Analgesia 117
Epidurals, Demerol, Fentanyl, Stadol, Morphine,
and Nitrous Oxide 117
Cervical Checks 126
External Electronic Fetal Monitor and Tocometer 129