Doing obstetrics : the organization of work routines in a maternity service

Despite popular and professional concerns with childbirth and prenatal care there are few empirical studies of behavior in hospitals where these events typically occur. The problem set for the study reported here was to observe behavior in the maternity department of a hospital and to provide a theoretical description of what was observed in terms relevant to sociologists' interest in the social organization of work routines of professional staff members serving a lay client population. The thesis is thus a description of medical staff members' work routines, with an analytic interest in how that relates to features of work routines of service occupations in general. Specifically, the study reports upon the ways lay patients may differ from professional medical staff members in their perspectives on prenatal care and childbirth and how staff members see these divergences as often resulting in organizational problems when they try to provide care which is "complete, " efficient and expeditious. Further, the study describes how staff members develop interactional (and other) methods for managing patients, especially those who adhere to these nonmedical perspectives, so as to cope with such practical pressures as the need to schedule patients and their demands, provide a visibly competent performance for superiors, peers and patients, and prepare the patient for efficient and expeditious processing at subsequent organizational stages. It is asserted that these practical pressures (termed demand characteristics) are features commonly found in work routines of service occupations in general. Finally, it is argued that an ethnographic study of work routines of professional staff members of service institutions, e_. g., hospitals, may be necessary to explain adequately features of apparently natural or biological events, such as childbirth, that occur within them.Arts, Faculty ofAnthropology, Department ofGraduat