Medical construction of midwifery. Representations and practices

Objective. To describe how discourse has been constructed regarding parturition (delivery) and the need for medical intervention in Spain. Methodology. This was a qualitative study. Interviews were conducted with seven midwives who practiced in Cataluña (Spain) during the middle of the last century. Their opinions were compared to medical discourse gathered from research published in the Spanish Journal on Obstetrics and Gynecology (Revista Española de Obstetricia y Ginecología) between 1954 and 1960. Results. Against the normality of the evolution of most parturitions reported by the stories of the midwives, in medical definitions these appear as problematic or altered in their duration and by the presence of pain, justifying their systematic interventions; although the aforementioned poses a risk for women and their offspring. As a result, the discourse defining most deliveries as pathological is reaffirmed. Conclusion. The medical system constructed midwifery as a surgical process. Women are engaged in other more realistic constructions in agreement to their needs. Care at birth is perceived as a cultural construction and, hence, susceptible to change.