Notes

[1] For discussions of how 'natural' and medicalized childbirths are narrativized, see Tess Cosslett, Women Writing Childbirth: Modern Discourses of Motherhood (1994). For critical analyses of women and illness during childbirth and invalidity as socially constructed cultural norms for women, see the following: Diane Price Herndl, Invalid Women: Figuring Feminine Illness in American Fiction and Culture, 1840-1940 (1993); Elaine Showalter, The Female Malady: Women, Madness, and English Culture, 1830-1980 (1985); Barbara Ehrenreich and Deirdre English, Complaints and Disorders: The Sexual Politics of Sickness (1973).

[2] For clarification, I will not address situations where complications and dangers have been diagnosed long before delivery.

[3] Williams has had an all-male board of editors since its early-twentieth-century appearance.

[4] I do not intend to implicate all health care providers since I have met female and male providers who have been extremely helpful and sensitive.

[5] If birth is a woman's experience, where is her validation in Williams, written exclusively by men since its first publication (Hahn 1987: 260-261)? In addition, Williams has been translated into five languages, a worldwide perpetuation of its dominance. After perusing numerous acknowledgments in earlier Williams editions, I noticed that the impressive lineage of male authors consistently thanked their patient, loving wives for support and understanding during revisions, reinforcing the painful irony of women's medical marginalization in childbirth issues. Hahn reminds his readers that Williams editors admit the text's chauvinism, yet nonetheless offer their wives only token acknowledgment of their significant contributions (1987: 280, second note). Buried in footnotes or introductions, women find their place in the spatial hierarchy of the text. Furthermore, no medical text of such stature as Williams has been published by female physicians who advocate feminist stances on labor and delivery. While women have entered the profession, their medical authority remains unscripted.

[6] Have these lay texts impacted medical texts and concomitant practices? Paula Treichler finds that such feminist discourses are a challenge to medicine and have thus been addressed increasingly (1990: 113).

[7] From Tess Cosslett's Women Writing Childbirth: Modern Discourses of Motherhood (1994: 5).

[8] Williams offers the following reasons for necessitating monitoring: 'because of the ease of operation, the constant threat of legal action [if the child dies during delivery] ... and simply because the trend to continuous electronic fetal monitoring has become almost an accepted reality, it seems highly unlikely that there will be less continuous electronic fetal monitoring' (1993: 376, emphasis mine). The 'trend,' not a woman's choice, figures heavily in the use of such equipment.

[9] Haire discusses other routinely overused procedures in the publication 'The Cultural Warping of Childbirth' (1972).

[10] Also see: a New York Times article by Sandra Blakeslee, 'Poor and Black Patients Slighted, Study Says,' where she contends that while such patients receive substandard care, 'the disparity is far less serious in big city teaching hospitals' (1994: 10); a New York Times article by Harriet A. Washington, 'Medical Victims' (1995); Ellen S. Lazarus' 'What Do Women Want?' for an in-depth investigation of how class affects care (1994).

[11] For a thorough investigation into the use of medical students in labor rooms, often positioning women patients at a disadvantage, see Michelle Harrison's A Woman in Residence (1982).

[12] For another analysis of 'the role of technology and social interaction' during birth, see Brigitte Jordan's Birth in Four Cultures: A Crosscultural Investigation of Childbirth in Yucatan, Holland, Sweden, and the United States (1993: 151), specifically chapter 6 (151-168).

[13] Not only must the laboring woman defer to her physician, but nurses and other medical staff 'below' the physician must do so as well (Brigitte Jordan 1993: 159).

[14] Two 1992 articles discussing the rise of birthing centers point out that community desires seem to be continually at odds with medical dictates. (Belkin 1992: A1+; Jingle 1992: B1+). The conference 'The Politics of Caring II' addressed the needs of midwives, nurses, and pregnant women. It was sponsored by Emory University, the Emory School of Medicine, and the School of Public Health.

[15] Since the staff's medical education competes with female birth experiences, this play of power, and what is at stake, dictates who is to be heard and who remains silent. The real issue, underlying the economic profit of the medical profession, is the mother's relation to childbirth, an experience in which women have historically felt out of control, at the mercy of biology, fate or chance. To change the experience of childbirth means to change women's relationship to fear and powerlessness, to our bodies, to our children; it has far-reaching psychic and political implications. (Rich 1976: 182) These political implications point to a repossession of choice and power in childbirth.