Medicalization

Question 1

define medicalization

Answer 1

process through which condition or behaviour becomes defined as medical problem requiring medical solution.
- extends medical jurisdiction +authority into broader areas of life.

Question 2

how does medicine exercise moral + social control

Answer 2

• 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

Question 3

life deemed relevant to good practice of medicine:

Answer 3

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

Question 4

retention of absolute control over certain technical procedures

Answer 4

ie. surgery, prescribe meds.

- > starting to change to certain degree.

Question 5

retention of near absolute control in access to human body

Answer 5

medicine has authority to touch living + dead. access to inner workings on body.
-> few professions that have access to interior of body

Question 6

the medicalization of childbirth:

Answer 6

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.

Question 7

3 ways medicine was successful in gaining control over childbirth

Answer 7

1. deemed it relevant to good practice of medicine.
2. through retention of absolute control over certain technical procedures
3. through retention of near absolute control in access to human body

Question 8

how deeming relevance to medicine = control over childbirth

Answer 8

science was trusted, science portrayed cb as risky event.

midwives depicted as dangerous, untrained (wisdom, experience > science)

Question 9

retention of absolute control over technical procedures - childbirth

Answer 9

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.

Question 10

retention of control over access to human body = childbirth

Answer 10

medical schools to train in childbirth procedures.
childbirth unsuitable for Victorian woman.
science + innovation taught how to access body for childbirth - c-section.

Question 11

two ways progression of medicalization of childbirth has occured.

Answer 11

1. relocation of childbirth from home to hospital

2. labour increasingly viewed as condition that requires medical surveillance + intervention

Question 12

relocation of childbirth

Answer 12

majority at home 1930s -> nearly 100% in hospital by 1960.

Question 13

why was there a transition from home to hospital?

Answer 13

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

Question 14

did transitio produce desired effect?

Answer 14

no. doctors did not completely reduce risk. still risk for some.
- women felt alienated. no control over birthing process

Question 15

labour viewed as condition that needs medical surveillance + intervention

Answer 15

do more = manage risk = better outcome
EF (fetal monitor)
Friedman curve
episiotomies

Question 16

EFM - what is it?
relate to medical model approach? when was it made?
rate of use in 90’s? in 2006?

Answer 16

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

Question 17

problems with EFM

Answer 17

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.

Question 18

c-section births rates?

Answer 18

not causal relationship with EFM, but deff saw increase in c-sections over time. now 1/5 have c-section

Question 19

countries + c-section rates.

Answer 19

2015 - 21% of all births.

-> worldwide c-sections are on the rise. alienating experience: event fully controlled by physicians

Question 20

friedman curve

• what is it?
• medical model?
• consequence?

Answer 20

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

Question 21

episiotomies - what is it?

- rates?

Answer 21

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%

Question 22

summing up medicalization of childbirth:

Answer 22

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