Pushing for New Options in Childbirth: A Case Study in Contemporary Integrative Midwifery

In this study, I investigate the concept of “integrative midwifery” in a major metropolitan area in the Southwest United States. Specifically, I look at a group of midwives, doulas, and other birthworkers who have organized into a collective business entity to provide services to pregnant and birthing women. Stemming from a perception that the medical model of maternity care is broken in this country, these practitioners seek to offer alternatives. I draw upon literature regarding complementary and alternative medicine (CAM) which shows that market conditions have created a situation in which alternatives to medical modes of care have become increasingly popular, and many consumers are choosing to use both models simultaneously. While CAM integration is an increasingly documented trend in medicine, few studies have examined the ways in which midwifery is integrating with medical institutions. This study explores the ways that these birthworkers appear to be seeking integration with the medical model which illustrates a larger picture of midwifery as a social movement. Based on a multi-method case study of this alternative birthwork collective, I examine how this group positions itself on a continuum from midwifery to the medical model of maternity care. I further examine how these workers negotiate that space using boundaries to distinguish themselves from others. I employ the notion of collective identity to understand how these workers validate and sustain their movement participation, and also project an image to the public that reflects their willingness to integrate these normally disparate models