Mary Elizabeth Cotter

Dissertation Committee:

Professor Hervé Varenne, Sponsor
Professor Hope Leichter

Approved by the Committee on the Degree of Doctor of Education

Date FEB 12 1996

Submitted in partial fulfillment of the
requirements for the Degree of Doctor of Education in
Teachers College, Columbia University


This single-case study examines selected features of interactions during "medicalized" childbirth, i.e., childbirth in a hospital setting. The ethnographic data include sixteen hours of videotaped interactions collected by following one pregnant woman through prenatal care, labor, and childbirth. Transcripts were developed, in varying levels of detail, for all sixteen hours of videotape. The two hours of hospital labor provide the main focus, and the issue of pain is a leit motif. This study builds on the work of Brigitte Jordan (1993), and examines data from the perspective of ethnomethodology.

The term "medicalized childbirth" glosses a complex web of interactions and negotiations; this study shows how participants use various aspects of the hospital labor setting as resources in their interactions. By examining aspects of both talk and nonverbal behavior, this study explicates some of the structural features of uterine contractions. Contractions, which at first appear to "belong" to the laboring woman, are shown to be socially organized, and to involve a series of behaviors not just of the laboring woman, but of other participants as well. Contractions displays, which are generally thought to be an inevitable feature of labor, are shown to be a function of their interactional context such that, at times, they seem almost to disappear.  In this respect, this study supports Heath's (1989) work on pain expression.

Other aspects of medicalized childbirth examined include the following: 1) the kinds, functions, character, and topics of talk during labor; 2) the interactional role of the fetal monitor; 3) how stories of past labors function as a resource in present interactions; and what interactional jobs that get done by such stories; 4) participation statuses of the interactants. Particular attention is given to the following question: is the pregnant woman's professional "identity" as a physician interactionally relevant in this setting?

For a further analysis of this case see How many doctors are there in this house

November 27, 1998.