Date of Award

12-16-2015

Degree Type

Thesis

Degree Name

Master of Arts (MA)

Department

Sociology

First Advisor

Dr. Wendy S. Simonds

Second Advisor

Dr. Anthony Hatch

Third Advisor

Dr. Ben Kail

Abstract

Numbers of caesarean sections, epidurals, and other forms of medical interventions for birthing are rising in the United States healthcare industry. One possible reason is the medicalization of birthing and labor techniques. Another potential reason is the increasing distinction between laboring in a hospital versus laboring in the home or an independent birthing center. The dominance of the medical model of birthing has led to social constructions of birthing that divide women by diagnosis, into either high-risk or low-risk prenatal categories, further perpetuating the medical model’s power to marginalize the midwifery model.

Forty percent of U.S. births are financed by Medicaid insurance. Because Medicaid insurance is based on the technocratic medical model, birthing providers that accept Medicaid insurance may be pressured, directly and indirectly, to adopt the medical model as the most appropriate birthing option, decentering the midwifery model. Inevitably, this potentially shifts birthing options and experiences for low-income women in the U.S. In order to understand how low-income women experience birthing in U.S birthing institutions, we first need to take a closer look at how birthing facilities socially construct birthing. Among many areas of influence for the social construction of birthing, website content has been neglected as a form of primary data. Using content analysis, this study investigates how web content aids in the social stock of knowledge on labor and delivery.

Analyzing the websites of three birthing centers and two public hospitals that accept Medicaid insurance in Miami, Florida, this study’s findings indicate that the language used on birthing center websites aligns with the midwifery model, but reverts to the medical model used by hospitals, in language and policy, when discussing cases of emergency birthing. The public hospital websites, meanwhile, appropriate the language and procedures of the midwifery model without providing the practical benefits of natural birthing.

Findings in this study also capture a snapshot of birthing models used by providers in Miami, Florida ahead of its 2016 transition from the Florida Medicaid system to the Federally-Funded Marketplace, as per the Affordable Care Act of 2009. By assessing how birthing providers socially construct birthing, we could reduce the underrepresentation of natural birthing, exposing low-income women to more balanced depictions of both the medical and midwifery models of birthing, possibly reducing negative socio-emotional outcomes during birthing, postpartum depression and maternity-mortality rates among the poor.

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