Divisions of Labor: Obstetrician, Woman, and Society in Williams Obstetrics, 1903–1985

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Abstract
During the 20th century the developed world has witnessed a fundamental revolution in the conduct of birth. Its place has moved almost entirely from domestic to medical settings, while obstetrical professionals have increasingly assumed control of its events. Powerful artifacts and procedures employed in the conduct of birth have proliferated concurrently and appear to exert a command of their own. This obstetrical revolution has occurred in a cultural environment of profoundly charged and rapidly changing values and practices regarding sexuality and reproduction, health and health care, identity, and autonomy. In this paper I focus on relations between obstetricians and childbearing women, as presented in the first 17 editions of Williams Obstetrics, the central reference text of this medical specialty. From the first edition in 1903 to the most recent in 1985, Williams has both reflected and guided the development of belief and practice in obstetrics. Early editions hold childbirth to be an essentially pathological event; childbearing women are its patients and require extensive medical monitoring and intervention. Though recent editions stress the social and psychological context of childbirth, this viewpoint has not yet fully informed the practices and attitudes that characterize the text.

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