High-Fidelity Birth Simulators in American Culture: An Ecofeminist Analysis

Mother was once a standard term for the womb, and rising of the mother, fits of the mother, and even simply mother were hysterical fits brought on by disturbance of the womb - "Hypochondria," The Aferriam-WebsterNew Book of Word Histories. Introduction Today, a new teaching tool, the high-fidelity birth simulator, is increasingly being promoted and implemented to educate aspiring medical professionals in the United States about childbirth. The machines are anatomically correct mannequins with the capacity to simulate some aspects of labor. The mannequin mother can be programmed to vomit as well as verbalize pain and anxiety. Equipped with a motor in its stomach, the machine is able to "birth" an accompanying mannequin child and placenta. Medical scholars Roaxane Gardner and Daniel B. Raemer tout the use of high-fidelity birth simulators as teaching tools for "identifying clinical error, reducing clinical risk, and improving clinical outcomes" (110). Proponents claim that birth simulators improve students' confidence, "time-management, leadership and critical thinking" (Leigh and Hurst 2). Gardner and Raemer go so far as to proclaim, "The days of relying on the apprenticeship style of learning in obstetrics and gynecology have passed" (Gardner and Raemer 119). What appears to be significantly lacking from the growing body of literature endorsing such teaching tools are the potential drawbacks of their use, including, for instance, their capacity to perpetuate the presentation of birth as pathological and birthing women as passive patients. While even some midwifery schools, at times, utilize such technology, they are always secondary to live models, role playing and first-hand experience (Phillips).1 Moreover, students are introduced to not only abnormal births but normal, mother-led births, too. Indeed, with some important representational adjustments, birth simulators might be acceptable as a means of teaching students basic anatomy and emergency birth scenarios. However, birth simulators are purposed to do much more than this. As Nelson explains, "They're teaching [medical professionals] how to manage a woman when she is in labor, how to manage a baby when they're in birth, which means taking absolute control. [They're] not leading by following what's actually happening, but they're learning to literally manage the whole thing." In her seminal 2010 article on birth simulation, "Obstetrical Nursing Experience Simulation, Filling the Gap," Deborah A. Raines makes the case for use of high-fidelity birth simulators to educate nurses on grounds that they provide important learning opportunities unavailable in the clinical setting. She writes, "A student or a new labor and delivery nurse could potentially complete an entire clinical rotation or orientation period and not experience some of the common or high-acuity events that a nurse needs to come into contact with to be prepared to provide safe and effective care" (112). Raines goes on to explain that "Highfidelity" birth simulators allow students "to apply knowledge and skills used to assess and intervene in patient care situations" (114). Absent from such analysis is any concern that medical professionals, nurses and obstetricians, alike, are likely to complete their medical training without having witnessed a normal birth, a birth that did not require medical intervention. One can certainly appreciate the desire to teach healthcare workers to practice medical techniques without threatening the safety of the "patient" (Raines 114). However, viewed through the lenses of ecofeminism and traditional midwifery, the ways that such birth simulators are being implemented tends to perpetuate a dualistic conceptualization of women and birth, in which birthing women and the natural world are backgrounded and dominated, while medical professionals are pushed to the foreground as birthing agents. Arguably, mannequin birth simulators epitomize and, thus, recapitulate the medical conceptualization of birth as a project that relies upon the supervision, technological control, and skill of the medical authorities rather than mothers and natural processes. …