From medicalisation to humanisation

In my visits around the UK and to different parts of the world over recent years, I have been struck by how intractable and pervasive the medicalisation of childbirth has become.

By medicalisation I do not mean medical care, which is a crucial part of maternity services. Medicalisation or medical control of birth may be characterised by excessive intervention, including caesarean sections (CS), instrumental deliveries and high rates of epidural anaesthesia, routine electronic fetal monitoring, as well as induction and augmentation—and still, in many parts of the world, elective episiotomy, routine shaves and enemas. Indeed, this is not reserved for high-income countries. Medical interventions, many without any scientific basis, pervade every corner of the world.

One aspect of this medicalised approach is that the power of respectful human support and importance of human relationships is often overlooked. Care is often fragmented and standardised.

Medicalisation is a process by which non-medical problems become defined as medical (Prosen and Tavčar Krajnc, 2013). This expansion of the medical jurisdiction over childbirth becomes a mechanism of social control through medical gaze and surveillance; normal processes become problematic, and a new consumer market is created (Prosen and Tavčar Krajnc, 2013). Medicalisation as social control in childbirth holds great power. Childbirth is a sensitive and critical point in human life, with the potential for enhanced health over the life span, or to do harm that may persist over a lifetime and even generations.