Mary M. Lay - The rhetoric of midwifery: gender, knowledge, and power
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The rhetoric of midwifery: gender, knowledge, and power
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Library of Congress Cataloging-in-Publication Data
Lay, Mary M. The rhetoric of midwifery : gender, knowledge, and power / Mary M. Lay. p. cm. Includes bibliographical references and index. ISBN 0-8135-2778-3 (cloth : alk. paper). ISBN 0-8135-2779-1 (pbk. : alk. paper) 1. MidwiferyMinnesota. 2. MidwivesLegal status, laws, etc.Minnesota. 3. MidwiferyPolitical aspectsMinnesota. I. Title. RG950.L39 2000 618.2'0233dc21 199-43562 CIP
British Cataloging-in-Publication data for this book is available from the British Library
Copyright 2000 by Mary M. Lay All rights reserved
No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, or by any information storage and retrieval system, without written permission from the publisher. Please contact Rutgers University Press, 100 Joyce Kilmer Avenue, Piscataway, NJ 08854-8099. The only exception to this prohibition is "fair use" as defined by U.S. copyright law.
Manufactured in the United States of America
Page v
To my parents
Page vii
Contents
Preface
ix
1 The Current Debate over Direct-Entry Midwifery in the United States
1
2 Rhetorical Analysis and the Midwifery Debates
20
3 The Rhetorical History of Midwifery
43
4 The Minnesota Midwifery Study Advisory Group: Professional Jurisdictions and Boundary Spanning
77
5 Licensing Rules and Regulations: Normalizing the Practice of Midwifery
101
6 Jurisdictional Boundaries: Claiming Authority over Scientific Discourse and Knowledge
131
7 Issues of Gender and Power: The Rhetoric of Direct-Entry Midwifery
170
Appendix A Additional Notes on Methodology and Sources
189
Appendix B Glossary of Birth Terms
195
Appendix C Rhetors Involved in the Minnesota Hearings and Chronology of the Hearings
201
Notes
207
Bibliography
219
Index
233
Page ix
Preface
Michel Foucault challenged scholars to investigate the local centers of the knowledge/discourse/power relationship, and, at first glance, this case study of the efforts of Minnesota traditional or direct-entry midwives to become licensed seemed an ideal way to meet that challenge. However, the study turned out to be much more than that. Between 1991 and 1995 the Minnesota Department of Health and Board of Medical Practice held public hearings to discuss the status of direct-entry midwives, who were practicing underground or a-legally in the state. Sitting across the table from each other for the first time were established physicians of obstetrics and gynecology, nurses and nurse-midwives who headed such organizations as Minnesota Nurses' Association and the regional chapter of the American College of Nurse-Midwives, malpractice lawyers, and direct-entry midwives. Although those midwives who belonged to the state midwifery Guild had been politically active, others were stepping into public view for the first time. Immediately, it became clear that this was a rare opportunity to study medical and midwifery practices in conflict, the use of discourse to maintain professional jurisdictions, the exclusive claim to scientific knowledge and discourse by dominant professions, and the cultural status granted to women's experience and knowledge of their bodies.
Certainly many fine books on midwives have been published in the last few decades. Many take a historical approach, some are based on interviews and life stories of practicing midwives, and some trace the legal battles of past and current midwives. This book is the first, I believe, to offer a rhetorical study of midwifery, to understand the arguments used to celebrate or suppress this centuries-old practice. Thus, the texts and public testimony originating within the Minnesota hearings provide the basis to understand the ideologies and value systems of midwifery and medical practice and why the two systems constantly seem in conflict. However, to place these texts and testimony in a broader context, I also looked back at the history of midwifery to capture the echoes from the past that resonated in the Minnesota hearings. I also relied on a source increasingly used by modern scholars: the Internet. Midwives across the United States and across the world share their feelings and protocols through computer mediated communication. They may still rely on natural remedies: herbs and the touch of their own hands to help mothers
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