Risk perceptions of natural versus 'medicalized' childbirth

Women were kept isolated in small rooms. Their arms were strapped down. Doctors were often methodically cold. And, upon the delivery, babies were swept away to isolation in a nursery.

Much of this has changed. But, some would argue, there still remain many vestiges of this "medicalized" approach to childbirth--a paradigm that is being challenged by more natural, drug-free options like home birth, duolas, and midwives. All of these options, argues Craig Thompson, professor of marketing at University of Wisconsin-Madison, are consumer choices dictated by a complex matrix of risk assessment.

"This study explores how dissident health risk perceptions are culturally constructed in the natural childbirth community, internalized by consumers as a compelling structure of feeling, and enacted through choices that intentionally run counter to orthodox medical risk management norms," explains Thompson in an article in the September 2005 issue of the Journal of Consumer Research.

When consumers perceive themselves as being at risk, they will more likely go with the norm. This especially holds true with regard to health-related choices. But, consumers are growingly uncertain when it comes to making decisions based on heath risks, such as those related to childbirth. Fostering this discussion are dissident groups, who often find dangers in practices that may be commonly considered safe.

Of these, Thompson sought to "analyze the narratives of consumers who have become socialized in the natural childbirth community. This community of reflexive doubt dramatically inverts the orthodox cultural view that a hospital is the safest place to labor." Thompson conducts in-depth interviews with ten couples that utilized natural childbirth means--both in-home and at the hospital. His findings highlight the struggles consumers deal with when approaching childbirth and the risks associated with both natural and "medicalized" childbirth.

"The risks singled out by the natural birth model express cultural anxieties over the unintended and dehumanizing consequences of technology; the disempowerment and loss of autonomy through the machinations of complex expert systems; and a political project of asserting a subjugated knowledge (midwifery) over the authoritative knowledge of the medical establishment (thereby recapitulating the historical power struggle between midwifery and obstetrics)," writes Thompson.

He concludes that "one could easily argue that membership in the natural childbirth community (and the awareness of that group identity) motivates the ardent pursuit of a valued gain--the idyllic, romanticized model of natural childbirth--whereas consumers who aspire to a similar ideal but do not plug into a natural childbirth network may, by default, settle for the status quo by laboring in a hospital birth suite."