BIRTH AND THE DIVISION OF LABOR: THE MOVEMENT TO PROFESSIONALIZE NURSE-MIDWIFERY, AND ITS RELATIONSHIP TO THE MOVEMENT FOR HOME BIRTH AND LAY MIDWIFERY. A CASE STUDY OF VERMONT.
Contributors: Michigan State University.
Published: 1983
Number of pages: 348
Subjects: Sociology, General.
Description: This is a study of the changing social organization of the work of birth attendance. I examine the process by which a profession (obstetrics) emerged and achieved hegemony, dominating an extensive division of labor. This relationship was subsequently challenged by several social movements which politicized birthing practices and critiqued physician hegemony.

This is a case study of Vermont; the primary source of data is interviews with nurse-midwives, lay-midwives, physicians and others. This material was supplemented by an informal content analysis of state newspapers as well as an extensive review of historical, sociological and medical and nursing literature which enabled me to locate the processes studied both historically and nationally.

Drawing on Larson's (1977) neo-Marxist analysis, I examined the processes by which nurse-midwives attempted to professionalize within a highly articulated medical division of labor.

This study focuses on conflicting claims to occupational jurisdiction and the processes by which a client revolt (the home birth movement) and client reform movements (in-hospital birth reform) alter the work terrain, creating new opportunities for emerging occupations (lay-midwives and nurse-midwives) and resulting in conflicts over the division of labor. It also examines the process by which segments of the dominant profession (colleague-centered physicians, especially obstetricians) resist or attempt to co-opt challenges to their monopoly while other segments (client-centered physicians, especially family practitioners) augment client revolts and align themselves with emerging occupations.

I concluded that within the hospital, the institutional matrix of the dominant profession, nurse-midwives have located a market which is inherently subordinate.

Acceptance of this location in the medical division of labor would assure that nurse-midwifery would never achieve one of the primary goals of professionalization: autonomy in practice. At the same time, the growth of nurse-midwifery practice in the obstetrician headed "team" has the effect of undercutting an independent market for midwifery services. This effectively places CNMs in hospital practice in market competition with lay-midwives and nurse-midwives in independent practice.

Potential directions of occupational trajectories and interoccupational relations are suggested.
Notes: Source: Dissertation Abstracts International, Volume: 44-07, Section: A, page: 2251.

Thesis (PH.D.)--MICHIGAN STATE UNIVERSITY, 1983.

School code: 0128.