The Social Construction of Infertility

Health and illness are not objective states but socially constructed categories. We focus here on infertility, a phenomenon that has shifted from being seen as a private problem of couples to being seen as a medical condition. Studying infertility provides an ideal vantage point from which to study such features of health care as inter‐societal and cross‐cultural disparities in health care, the relationship between identity and health, gender roles, and social and cultural variations in the process of medicalization. Infertility is stratified, both globally and within Western societies. Access to care is extremely limited for many women in developing societies and also for marginalized women in some highly industrialized societies. We also discuss the ways in which responses to infertility are influenced by the process of self‐definition. The experience of infertility is profoundly shaped by varying degrees of pronatalism and patriarchy. In advanced industrial societies, where voluntary childfree status is acknowledged, many women experience infertility as a ‘secret stigma’; in other cultures, where motherhood is normative for all women, infertility may be impossible to hide. In the West, acceptance of the medical model is virtually hegemonic, but in other societies medical interpretations of infertility coexist with traditional interpretations.     

An Australian history of the subordination of midwifery

This paper analyses the history of the subordination of midwifery to medicine and nursing. With the important exception of Evan Willis’ work on medical dominance and Annette Summers’ work on the takeover of midwifery by nursing, other histories of Australian midwifery have taken a neutral approach to issue of power and control. The aim of analysing this period is to identify the strategies of power that were used to subordinate midwifery. With increased consciousness of how power has operated in the past, midwives and woman of today can be more empowered when seeking to promote normal birth and midwifery models of care.Concepts of ‘power’, ‘the state’ and midwife are defined and discussed. A summary of the decline of midwifery and the rise of obstetrics in Europe and the United Kingdom (UK) gives a background against which to understand the Australian experience. The historical account given here draws to a climax by focussing on the period 1886–1928. It was during this time that medicine forged an alliance with nursing and achieved both legal and disciplinary control of midwifery. Knowing how this was done is important because it helps us to recognise the power strategies that are currently being used by medicine. This is helpful when planning how these strategies might be matched or countered by contemporary woman and midwives when seeking to promote normal birth and midwifery models of care.     

RECONSTRUCTING DAILY LIFE IN THE PAST: AN HERMENEUTICAL APPROACH TO ETHNOGRAPHIC DATA

Traditional sources of sociohistorical data capture only a narrow sense of past lifeworlds. Ethnographic accounts often preserve greater details of social practice but have less clear guidelines for use as data. We evaluate the use of hermeneutical theory as providing guidelines for a method by which ethnographies may be used as sociohistorical data. Hermeneutical analysis of ethnographic "texts" is used to reconstruct patterns of daily life in early-twentieth-century rural Appalachia. This method involves: (1) concept-critique to separate observations from the theoretical framework of the ethnographic account, and (2) validation through a logic of internal consistency and comparison. Through hermeneutical analysis, ethnographics can be made to yield observations of social relations not otherwise available. Our analysis suggests benefits and drawbacks of hermeneutical analysis of ethnographic texts.     

Attention deficit disorder: Problems with preconceived diagnosis

The diagnosis of attention-deficit/hyperactivity disorder (ADHD) has become a household term with many inaccurate conceptions and expectations. The label is being applied to children with a broad range of mental health problems and developmental disorders. This study looks at the impact of preconceived diagnosis on assessment and treatment of children and adolescents. Alarming trends of overidentification of ADHD, which lead to inappropriate treatment and management, are identified. Other causes of the target symptoms are discussed. The impact of preconceived diagnosis on treatment outcome, patient functioning, and other areas are addressed. The need for greater community awareness of the broad spectrum of disorders of childhood and adolescence is identified.