A Social History of Cesarean Section in the United States

描述（由申请人提供）： 从1965年到1987年，美国的剖腹产率上升了455%，从4.5%上升到25%。虽然剖腹产是一个适当的和必要的程序，在这些出生的显着数字，世界卫生组织（WHO）长期以来估计，最佳的剖腹产率是5%至10%的出生率，而超过15%的比率往往弊大于利。最近的研究似乎证实了世卫组织的断言，即高剖腹产率对基本上低风险的人口的影响在金钱和健康方面都是昂贵的。 这本书将是第一本深入探讨19世纪和世纪美国剖腹产社会史的书，也是第一本研究历史、文化和社会问题的书，除了医疗因素之外，这些因素导致了今天32%的剖腹产率。本书有四个目标：（1）检查“正常”分娩和分娩的定义在19世纪和20世纪是如何变化的，并研究这种变化对分娩期间医疗干预的非专业和医学观点的影响，特别是剖宫产的表现。(2)探讨标准产科治疗在同一时期的变化，特别是当医务人员遇到他们认为有问题的分娩时。(3)研究与出生有关的风险的含义如何随着时间的推移而变化，并研究这种变化如何塑造医学和非医学界对阴道分娩与剖腹产的态度。(4)研究似乎与健康和医学无关的历史，社会和文化力量如何塑造医疗决策和标准医疗实践，特别是在出生等竞技场中，这是一个代表了许多社会希望和关注的事件。 从本质上讲，这部社会史将研究历史，社会，文化和医疗因素，塑造标准的产科实践，使用剖宫产作为案例研究。作为医学历史学家，P.I.将追溯剖宫产的社会和文化背景在大约200年的时间，从当时的操作是最致命的外科手术之一，到今天的医疗和外行社区认为剖宫产是可比的，有时，更可取的阴道分娩。 这本书的数据将从母亲和医生的口述历史采访和无数的档案和出版的来源，包括妇女的信件和日记，医生的个人文件，产科教科书，在医学期刊，报纸和杂志的文章，医生的病例，躺在医院病例;医疗慈善机构、家庭分娩服务机构、妇产医院、生育改革组织、医疗和健康保险组织的文件;怀孕和分娩指导手册;以及医生和妇女的传记和自传。

DESCRIPTION (provided by applicant): Between 1965 and 1987 the cesarean section rate in the U.S. rose 455 percent, from 4.5 percent to 25 percent of births. While cesarean section was an appropriate and necessary procedure in a significant number of these births, the World Health Organization (WHO) has long estimated that the optimal cesarean section rate is between 5 and 10 percent of births and that a rate above 15 percent is apt to do more harm than good. Recent studies seem to corroborate WHO's assertion that the effects of a high cesarean section rate on a largely low-risk population are costly in both monetary and health terms. The proposed book will be the first in-depth social history of cesarean section in the 19th- and 20th- century U.S. and the first to examine the historical, cultural, and social issues, in addition to the medical factors, that have contributed to today's cesarean section rate of 32 percent. The book has four objectives: (1) To examine how the definition of "normal" labor and birth changed over the course of the nineteenth and twentieth centuries and to study the effect of that changing definition on lay and medical views of medical intervention during birth, particularly the performance of cesarean section. (2) To explore how standard obstetric treatment changed over this same period, particularly when medical personnel encountered a birth they deemed problematic. (3) To examine how the meaning of risk in relation to birth changed over time and to study how this change shaped medical and lay attitudes toward vaginal versus cesarean birth. (4) To study how historical, social, and cultural forces seemingly unrelated to health and medicine shape medical decisions and standard medical practices particularly in an arena such as birth, an event that represents so many societal hopes and concerns. In essence, this social history will examine the historical, social, cultural, and medical factors that shape standard obstetric practices, using cesarean section as a case study. As a historian of medicine, the P.I. will trace the social and cultural context of cesarean section over a roughly 200-year period from a time when the operation was among the most fatal of surgical procedures to the present day when the medical and lay communities view cesarean section as comparable and, at times, preferable to vaginal birth. Data for this book will be culled from oral history interviews with mothers and physicians and myriad archival and published sources including women's letters and diaries; physicians' personal papers; obstetric textbooks; articles in medical journals, newspapers, and magazines; doctors' casebooks; lying-in hospital casebooks; the papers of medical charities, home birthing services, lying-in hospitals, birth reform organizations, and medical and health insurance organizations; pregnancy and childbirth advice manuals; and physicians' and women's biographies and autobiographies.