Experiences with hospital transport for planned home births

xiii, 307 p.The midwifery model and the medical model constitute the two main bodies of knowledge and practice that characterize the way pregnancy and birth are viewed in the United States. The midwifery model emphasizes the normalcy of pregnancy and birth, while the medical model is characterized by a belief in the supremacy of technology over nature and in medical supervision and intervention during pregnancy and delivery. Although both models do espouse important information regarding pregnancy and birth and, at times, there is overlap in the practical application of the models, practitioners of the two models rarely interact with one another. The one situation where practitioners of these two models do come into contact is during home-to-hospital transports for planned home births. Through in-depth interviews with direct-entry midwives, mothers, obstetricians, and nurses, this dissertation explores what happens when practitioners of the two models are forced to interact during home-to-hospital transports in order to provide care for women and their babies. Building on Davis-Floyd's and Johnson and Davis-Floyd's work on home-to-hospital transport, interview data suggest that a series of professional and organizational level factors influence the interactions between obstetricians, direct-entry midwives, and nurses during transports. Findings indicate that care providers engage in emotion work as they navigate the disjuncture between home and hospital, managing their own feelings and the feelings of others during a home-to-hospital transport. Due to the lack of institutionalized protocols governing conduct during transports, practitioners of the two models of care are left to construct their own versions of protocols through micro-level interactions, which at particular times and among certain providers have the effect of transcending the boundaries that divide home and hospital. With the interaction that occurs during a home-to-hospital transport as the central focus, this dissertation provides insight into how the lack of integration between the more marginalized midwifery model and the dominant medical model of care in the U.S. affects care providers and laboring/birthing women during transport situations.Committee in charge: Jocelyn Hollander, Chairperson; Yvonne Braun, Member; Linda Fuller, Member; Carol Stabile, Outside Member; Melissa Cheyney, Non-UO Membe