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Piercing the veil: The marginalization of midwives in the United States

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  • Goodman, Steffie

Abstract

This paper investigates the marginalization of certified nurse-midwives (CNMs) in the US. This marginalization occurs despite ample evidence demonstrating that a midwifery model delivers high-quality cost-effective care. Currently midwives attend only 7% of births, compared to 50-75% of births in other developed countries. Given the escalating costs of health care and relatively poor maternal and child health indicators in comparison with other developed countries, these findings are disturbing. This paper investigates this paradox through a qualitative case study of two prestigious but declining midwifery services in a large US city. Fifty-two multi-sited in-depth interviews were conducted along with an analysis of relevant archival sources. It was found that institutions successfully altered maternity care and diminished midwifery services without accountability for their actions. These findings illuminate the larger political-economic forces that shape the marginalization of midwifery in the US.

Suggested Citation

  • Goodman, Steffie, 2007. "Piercing the veil: The marginalization of midwives in the United States," Social Science & Medicine, Elsevier, vol. 65(3), pages 610-621, August.
    • Handle: RePEc:eee:socmed:v:65:y:2007:i:3:p:610-621
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    References listed on IDEAS

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    1. Bourgeault, Ivy Lynn & Fynes, Mary, 1997. "Integration lay and nurse-midwifery into the U.S. and Canadian health care systems," Social Science & Medicine, Elsevier, vol. 44(7), pages 1051-1063, April.
    2. Jackson, D.J. & Lang, J.M. & Swartz, W.H. & Ganiats, T.G. & Fullerton, J. & Ecker, J. & Nguyen, U., 2003. "Outcomes, Safety, and Resource Utilization in a Collaborative Care Birth Center Program Compared with Traditional Physician-Based Perinatal Care," American Journal of Public Health, American Public Health Association, vol. 93(6), pages 999-1006.
    3. Elizabeth Docteur & Hannes Suppanz & Jaejoon Woo, 2003. "The US Health System: An Assessment and Prospective Directions for Reform," OECD Economics Department Working Papers 350, OECD Publishing.
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    Cited by:

    1. Siddiqui, Shayzal & Smith-Morris, Carolyn, 2022. "Professional competition amidst intractable maternal mortality: Midwifery in rural Pakistan during the COVID-19 pandemic," Social Science & Medicine, Elsevier, vol. 313(C).
    2. Pieters, A.J.H.M. & van Oorschot, K.E. & Akkermans, H.A., 2012. "Care & cure combined : Using simulation to develop organization design theory for health care processes," Other publications TiSEM cde21ab0-f8d7-4056-a98e-0, Tilburg University, School of Economics and Management.
    3. McCabe, Katharine, 2016. "Mothercraft: Birth work and the making of neoliberal mothers," Social Science & Medicine, Elsevier, vol. 162(C), pages 177-184.

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