The Formation and Transformation of the Medical Discourses about Episiotomy—The Medical Knowledge and Paradigm Shift of Natural Childbirth
Date Issued
2005
Date
2005
Author(s)
Tseng, Chia-Lin
DOI
zh-TW
Abstract
OBJECTIVES. This research is tried to analyze the medical discourses of formation and transformation about episiotomy in the obstetrics practice inside and outside Taiwan. And episiotomy is regarded as an important indicator of the paradigm of natural childbirth and it can be compared in the different social contexts.
MATERIAL AND METHODS. Archives Analysis and field study were used to examine the medical discourses about episiotomy. Different electronic databases such as Medline, PsyLIT, SSI , ProQuest were searched by the keyword “ episiotomy”. Different editions of Williams Obstetrics, and the influential announcement or practical guidelines among the important organizations were also inspected. In the context inside Taiwan, lecture notes, textbooks, communications in the obstetrics community, newspapers and public journals were analyzed. Besides, Field studies in Germany and one Taipei regional hospital were described.
RESULTS. The medical discourses about episiotomy were constructed under different points of view. The formation about the benefits of episiotomy was established in 1930s. Then the pathological assumptions put the natural childbirth into more medical intervention and episiotomy was gradually accepted in different societies. But it was transformed in 1990s. The reasons come from the results of the women’s health, natural childbirth movement, professional competitions, and the evidence based researches. Compared the overseas conditions, it seems that most Taiwanese obstetricians are not affected by the latest transformation due to obstetrics dominance, mostly institutionalized childbirth, and the newly childbirth movement involvement. The “High Tech” values among physicians make them ignore the importance of restricted use of episiotomy , which is a ”Low Tech” but “High Art” procedure.
CONCLUSIONS. From the history of the formation and transformation about episiotomy, we know that the medical Paradigm of childbirth can be challenged. The obstetrical practice in Taiwan needs further scientific, psychosocial assessments and aggressive attentions towards women’s health.
Subjects
自然產
典範轉移
醫學史
醫學論述
婦產科
Episiotomy
Childbirth
Obstetrics
Medical History
Medical discourse
Paradigm shift
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-94-R91845104-1.pdf
Size
23.31 KB
Format
Adobe PDF
Checksum
(MD5):e8c0956c965fb7cba4a4ac213ba38e2c