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The Midwifery Model

The Medical Model

The woman maintains power and authority over herself.

Power and authority are handed over to the physician and institution.

Responsibility is in the hands of the woman herself, shared with her midwife.

Responsibility is assumed by the physician.

The goal is to assist the woman toward self-care as a healthy person in a state of normalcy.

The woman is encouraged to be dependent and is treated as potentially ill and in an abnormal state.

The mother and baby are a unit whose medical and emotional needs are complementary; what meets the needs of one meets the needs of both.

The mother and baby are separate patients whose medical and emotional needs may conflict; the mother's emotional needs may jeopardize the baby's health.

The woman's body is a well-functioning home for herself and her baby. Its needs and workings are best known by the woman herself.

The woman's body is a mechanical organism that needs fixing. Its needs and workings are best known by the physician.

The emphasis is on pregnancy and birth as times of physical/ psychological/ emotional growth for the mother and fetus.

The emphasis is on pregnancy and birth as times of stress and danger.

Childbirth is seen as an activity that the healthy woman engages in.

Childbirth is seen as an occasion for the provision of medical services.

The midwife guides and educates the woman during her experience.

The physician manages the care of the woman.

Childbirth is seen as an event in the lives of the woman and her family. The woman's active birth-giving is enhanced by education, support, and skilled care.

Childbirth is seen as a surgical procedure (obstetrics is a surgical specialty) performed on the pelvic region of a woman, involving the removal of a fetus and placenta.

Adapted from In Labor: Women and Power in the Birthplace by Barbara Katz Rothman