Birth as an American Rite of Passage

by Robbie E. Davis-Floyd

This classic book, first published in 1992 and again in 2003, has inspired three generations of childbearing people, birth activists and researchers, and birth practitioners―midwives, doulas, nurses, and obstetricians―to take a fresh look at the "standard procedures" that are routinely used to "manage" American childbirth. It was the first book to identify these non-evidence-based obstetric interventions as rituals that enact and transmit the core values of the American technocracy, thereby answering the pressing question of why these interventions continue to be performed despite all evidence to the contrary. This third edition brings together Davis-Floyd's insights into the intense ritualization of labor and birth and the technocratic, humanistic, and holistic models of birth with new data collected in recent years.

Genres: Nonfiction, Anthropology, Health, Parenting, Medicine, Feminism, Sociology

442 pages, Paperback

First published October 5, 1992

Reviews

[Marla · Rating 4 out of 5]

I read this as part of my training to become certified as a birth doula. An anthropological study of the "routine" practices of obstetrics today, how they came into play, and why women tend to go along with the status quo even after negative experiences. The author goes into detail about commonly, and often routinely used obstetrical interventions, even though their efficacy has long been called into question. She analyzes how different kinds of women internalize the messages they receive from their childbirth experiences, and how that affects their feelings and reactions about and to childbirth afterwards. She also examines the medical training of obstetricians and how that shapes the current view of childbirth as pathology instead of a normal and healthy function of the female body. The author puts all of this in the perspective of ritual that supports our society's core values as a technocratic society. I didn't always "buy" that context, but there is sooo much great information in this book - from technical procedures to how important childbirth is to the family as a whole - I enjoyed it so much. It is written a bit "textbooky", and I referred to my dictionary several times (my new favorite word is "hegemony"). But the perspective I came away with was well-worth the effort to read this book.

[Amie · Rating 5 out of 5]

Mindblowing. On my journey towards learning more of the truth about birth in America, one niggling issue for me has been "Why do women continue to put up with this?" This book answers that and more. It takes a bit of time to truly get engrossed in the anthropoligical symbolism Davis-Floyd applies but once you do, man, what she says makes sense. Another great read for anyone interested in how women birth is important to feminism. The book is very obviously slanted towards homebirth, and she talks about practices in the hospital that are outdated and basically obsolete, but it is still highly relavent because they DID go on at one point, and it's important to examine why they persisted. Also a very interesting chapter on medical school as a rite of passage and the struggle doctors must endure to retain their humanism in the face of those rituals. Just a phenomenal, controversial read!

[Maggie · Rating 5 out of 5]

This is a seriously fascinating book, exploring birth in the US from an anthropological point of view. - specifically the very orchestrated hospital birth.

In a 79 page chapter called “Birth Messages”, she walks through the “standard procedures for normal birth” - with the
description/physiological effect/ritual purpose of each step of the way:

Wheelchair
The “Prep” - hospital gown, shaving, enema
Bed
Fasting
IV line
Pitocin
Analgesia
Artificial Rupture of Membranes
Electronic Fetal Monitor (external)
Electronic Fetal Monitor (internal)
Cervical Checks
Epidural/Caudal Analgesia/Anesthesia
“You’re 10cm - Now Push / Don’t Push”
Transfer to the Delivery Room
Lithotomy Position
Sterile Sheets, Disinfectant, Hand-Strapping
Episiotomy (and notes on Forceps and C-Section)
Mirror
Apgar Score
Washing the Baby
Prophylactic Eye Treatment
Vitamin K Injection
Bonding Period
Four- to Twelve-Hour Separation
Bassinet/Warmer
Wheelchair

Another really interesting chapter is the one called “Obstetric Training as a Rite of Passage” - that is, how doctors become doctors via a kind of hazing through medical school, internship, residency.

Worth reading.

[L H · Rating 4 out of 5]

A philosophical and scientific analysis of the technocratic model of childbirth, contrasting it with a more humanistic approach. Written by a medical researcher and anthropologist. Written for the general public, highly readable. Some of it is historical (i.e. dated), giving insight into how current maternity care practices came to be.

[Zoya Deen · Rating 5 out of 5]

as a woman who will never give birth, this book still holds such valuable insights for me into american perspective of women, their bodies, and their power. with the imagery of our medical system as a powerful form of cultural representation as well as a fully fleshed out narrative of the technocratic model of reality which is so prevalent here, floyd so expertly forces you to accept the reality of a paradigm which is simultaneously alienating women from their political power but also from their physiological power. freaking wow

[McKenna N]

read this for a class, so I won’t be rating it on enjoyment!

[Julie · Rating 4 out of 5]

this is a very important book. it may be a little heavy on the (anthropological) jargon for some people but it is worth it. it's an eye-opening study of the medicalization of birth in our culture and it's really interesting, upsetting, and informative. she includes many interviews with women who have birthed in hospitals and obstetricians describing their socialization/training/beliefs. i do believe that any woman giving birth owes it to herself to explore this issue. it is actually statistically less safe for low-risk women to deliver in a hospital than at home with a competent midwife (in terms of maternal & fetal infections and deaths). whether you already know that you want an epidural or if you are hoping for a natural birth, you should become aware of the practices that are commonplace in hospitals so that you can make informed decisions about what is right for you and your baby. it is possible (though very challenging) to have a "natural" birth in a hospital but it is a constant uphill battle to avoid the numerous dangerous interventions the medically-oriented practitioners try to push on women without evidence that they help (indeed, with research that shows that they hinder the progress of labor or make recovery more difficult for the woman).

[Brandee · Rating 4 out of 5]

Robbie Davis-Floyd brings about a sharp beam of light into the world of American birth and the various ways our culture allows it. She is a midwife and a childbirth educator and started this book as a social science study. She interviews mothers, midwives and OB's in order to glean info on what birth is in a hospital setting, a home setting and birth centers. She talks about the enculturation of women as soon as they enter a hospital (starting with the wheelchair that they meet you at the door with) and the loss of control that many women feel as they move this process. However, she also covers in good detail the ways in which many women are able to use technological birth to their advantage without losing theirselves and their birth experiences to the machine. I've read this as part of my midwifery education, but I don't recommend reading it while pregnant. I had to keep saying, "this isn't about me, this isn't going to happen to me". This is an absolute must-read for every person because birth is topic that must be understood and not entered into blindly.

[Ilana · Rating 5 out of 5]

Really interesting book, especially if you're at all interested in issues of birth and/or how the medical system instills and promotes certain values in our culture. Floyd-Davis argues that the way birth occurs in hospitals serves to "initiate" women not only into the role of being a mother but also of what it means to be a member of our society (specifically the need to accept such values as the dominance of science, the body as a "machine," and fear of the female body). She contrasts the technocratic (primarily occurs in hospitals) and wholistic (primarily occurs out of hospitals, at home or in a birth center) models of birth, and the impact each model has on women and society at large. The book isn't always reader-friendly at times (can be dense, academic language), but once you get into it it's fascinating.

[Hannah Sheree · Rating 4 out of 5]

At times a little heavy-handed on the feminism, and potentially adding more symbolic reality to certain things than actually are (recall how in English classes the curtains being blue signified the authors depression, when actually the curtains were just blue because the author liked the colour?), this is a fantastic book that explores the medicalisation of childbirth in the USA. It was a gripping book for the most part, with statistics to support the stories of these women. I can't tell if this has made me want to have children more, or less...

Either way, for those interested in feminism, US culture, the medical industry, and childbirth, this is a fantastic book absolutely worth your time reading.

[Laura · Rating 3 out of 5]

The underlying message regarding the "technocratic" system of birth in the United States is true and resonates today, but the majority of the author's references were from the 1980s and before and the author is verbose and belabours her points extensively. Much of the research used is outdated so the statistics are no longer valid and some of the medical interventions that were prevalent then are not frequently used now. However, birth as a ritual is absent in the American culture and it would be wonderful if women were allowed to experience their birth as they want to without unnecessary medical interventions.

[Brooklyn James · Rating 5 out of 5]

The anthropological view of birth is truly fascinating! The rites and social/cultural impact discussed within are eye opening. A VBAC home-birther to our second child after a highly intervened upon and technocratic hospital birth, I found myself in Davis-Floyd's narration. This book should be required reading for any and all medical students inclined to serve pregnant and birthing women (i.e. obstetrics/gynecology—midwives, doctors; postpartum/labor & delivery—RNs, LVNs & PCTs). Doulas and birth partners would do themselves, and their partners, a favor in reading this book. Even hospital administrators should be required to read this book.

[Nev]

This was jaw-dropping on the first page. I had never read any lengthy anthropological works, and this book made an impact on me in a lot of ways. Its incredibly powerful thesis is well-supported within the book and easy to buy. I wish I could find something a) more recent or b) by another author on the same topic just to help give me some perspective. I say this because I have a giant crush on this book and I wish I could think of it more critically.

[Kim · Rating 5 out of 5]

Easily one of my favorite books, and probably the book most influential on my research orientation for my master's work.

This book is a basic, anthropological exploration of the technocratic system in which women in America give birth. It looks at childbirth as a quintissential right of passage, and argues that technocratic births are designed to inculcate core American values (control, science.)

[Shannon · Rating 5 out of 5]

Textbook style book.
Read until to the Birth Messages chapter. Breaks down all of the hospitals standards practices, the medical "reasons" for them, and gives testimonials of women's reactions to the practices.
Also, the Obstetrics as a Rite of Passage chapter is great. Talks about the process of desensitizing med students in the first two years of med school so they are able to see each situation as a "case" rather than a "person".

[Jennifer · Rating 4 out of 5]

I actually read the older version with the red and white, striped cover. I was taking Robbie Davis-Floyd's class in college. The experience was absolutely eye-opening. Although some of the information (in the older version) was outdated for the current birthing environment, it was still an excellent read. I assume the newer version has updated information.

[Isaac Lord · Rating 3 out of 5]

This is a well-researched treatment of the topic, but circa 1993 (I think). A lot of the information is now quite dated, especially concerning the legal issues around birth. For a much more current (and very gripping) book on the same subject, try 'Pushed: The Painful Truth About Childbirth and Modern Maternity Care' by Jennifer Block.

[Jenny · Rating 3 out of 5]

Interesting book about how birth has changed in the US over the past century and the pros/cons, mostly the cons. It has tons of sources and information but I thought it was a little boring and all the footnotes and parentheses broke up the reading.

[Monica · Rating 4 out of 5]

this is a leftover from my college days - the author was a professor - and it was the first glimpse for me of a different way of viewing traditional hospital births.

[Angela · Rating 4 out of 5]

Not a super easy read, but very eye-opening. Robbie Davis-Floyd unpacks the rituals of pregnancy, birth and the culture of biomedicine.

[Lillibet Moore · Rating 4 out of 5]

love this book, especially the more I read

[Kit · Rating 5 out of 5]

Clearly shows how birth, particularly supporting natural/homebirth, should be part of a feminist agenda.

[Terra · Rating 4 out of 5]

Great subject matter, and interesting read, but very dry.

[wendy Burrows]

I started to read this book and it just didn't do it for me.

[Allison · Rating 5 out of 5]

This book should be read by every woman.

[Susan]

Anthropology, birth, and book-writing. I am So Jealous!

[Stephanie · Rating 5 out of 5]

Of all the birth related books I have read, this is by far my favorite!