Obstetric Decision-making in Hospital-based Childbirth

• In Event: 1184 - Section on Organizations, Occupations, and Work Refereed Roundtable Session
  In Refereed Roundtable 100min: Table 03. Healthcare and Medicine

Abstract

In recent decades the United States has witnessed a steady rise in rates of cesarean section delivery in hospital childbirth, with approximately one third of total births ending in c-sections. That cesarean section delivery presents additional risks to short- and long-term maternal health motivates questions about the implementation of and justification for c-section delivery methods by medical providers. This paper attempts to decipher how medical providers determine that c-sections are necessary during childbirth by identifying the underlying mechanisms of provider decision-making in contemporary hospital childbirths. Using in-depth interviews with nineteen physicians, obstetricians, Certified Nurse Midwives, and labor and delivery nurses in three Midwestern states, this study addresses a gap in current research by answering questions about provider rationalization of cesarean section deliveries. I find that maternal health providers make medical decisions during childbirth according to individual perceptions, communication, and interactions during labor and delivery. I argue that adaptations in labor and delivery are mediated by technology that enables and constrains providers’ practices while also legitimating decision-making. Further research exploring patterns in these interactions can help alleviate misdiagnoses and unnecessary interventions in hospital childbirths.

Author

• Amelia Hawbaker, Indiana University