Always, already-medicalized: Women’s prenatal knowledge and choice in two Canadian contexts

Abstract

Women’s childbirth choices occur within contested discourses about medical, natural, and woman-centered births. All three perspectives, to slightly differing degrees, presume an autonomous female subject who makes childbirth choices. Thus informed choice is posed as a crucial corrective to the increasing medicalization of childbirth. This article employs a critical feminist analysis to examine how women learn about childbirth and make choices long before the moment of informed choice. Interviews with 40 pregnant and recently birthing women in two cities in Alberta, Canada illustrate how media, family and friends, and prenatal courses comprised core pre-birth knowledge systems informing women’s decision-making. The interviews exposed how medicalization is naturalized in these knowledge systems, so that women approached their actual births with an already-medicalized set of perceptions. This already-medicalized knowledge foreclosed women’s choices, a finding that complicates arguments over improving informed choice during childbirth as a means of reducing childbirth medicalization.