People vs.
Policy
By
C. Claiborne Linvill
Thesis Proposal
People vs. Policy: A Comparative Discourse Analysis of
Childbirth Caregivers in America
June 2010 C. Claiborne Linvill
clinvil@clemson.edu
INT.HOME.DAY
Historic image of a laboring mother and midwife
NARRATOR V.O.
For centuries, the midwife was the
leading, and often only, choice for
childbirth care in America. Birth
was viewed as a natural process,
not a sickness, so mothers labored
and delivered at home, surrounded
by other women.
INT.HOSPITAL.DAY
Historic image of a obstetrician and mother
NARRATOR V.O.
Starting in the 1800s, doctors
became involved in childbirth care,
arguing that their formal medical
education and new tools made them
superior to midwives.
INT.HOME.DAY
1950s to 1970s-era image of a laboring mother with a midwife
during a home birth
NARRATOR V.O.
The medical establishment’s
arguments became the dominant
discourse, and by the 1930s,
midwives delivered only 30% of
births, mostly attending to
immigrants and the poor. By the
1970s, only 1% of mothers used
midwives.
INT.HOME OR BIRTH CENTER.DAY
Modern-day image of a laboring mother with a midwife during
a home or birth-center birth
NARRATOR V.O.
The midwife was saved from
obscurity by the women’s lib
movement of the 1970s, when women
called for a more natural
childbirth experience. Today, 4% of
(MORE)
(CONTINUED)
CONTINUED: 2.
NARRATOR V.O. (cont’d)
vaginal deliveries in the U.S. are
assisted by midwives.
INT.HOSPITAL.DAY
Modern-day image of a laboring mother in a hospital
NARRATOR V.O.
Clearly, 96% of women align
themselves with the dominant
culture of doctor-attended births
in hospitals. Birth has been
defined in our culture as a medical
issue that needs to be attended by
hospital staff.
INT.OFFICE OF UPSTATE OB-GYN.DAY
Brief interview with DR. STEPHANIE DACH, OB-GYN, answering
the questions "How do obstetricians care for women?" and
"Why should a woman choose to be attended by an obstetrician
during birth?"
Key words the doctor uses appear at the bottom of the
screen.
INT.COLLINS’ OFFICE.DAY
Brief interview with CAREY COLLINS, midwife, answering the
questions "How do midwives care for women?" and "Why should
a woman choose to be attended by a midwife during birth?"
Key words the midwife uses appear at the bottom of the
screen.
INT.HOME.DAY
Images of pregnant women and women with babies (variety of
times/settings) slowly scroll across screen.
NARRATOR V.O.
The rhetoric that midwives and
obstetricians use to describe their
childbirth care separates the
groups into two clear discourse
communities. One could say that the
two groups, even as they serve the
same patients, aren’t even speaking
the same language.
(CONTINUED)
CONTINUED: 3.
If we can understand this language,
we can better understand the type
of care available for expectant
mothers. And by better
understanding the two main options
for childbirth care, we can educate
future women as they make decisions
about their birth attendants in
America’s changing health care
environment.
