OU-HCOM researcher receives federal grant
to study the history of c-sections
July, 2011
Jacqueline Wolf, Ph. D., professor of the history
of medicine at the Ohio University Heritage College of Osteopathic
Medicine (OU-HCOM), received a $150,000, three-year grant from the
National Institutes of Health to fund research for her next book
project, “A Social History of Cesarean Section in the United
States.”
Wolf, who is also the chair of the
Department of Social Medicine, describes the project as a historical
examination of births by cesarean section and changing medical
indications for cesarean section from the mid-19th century to the
present. The book will have a special focus on the social and
cultural factors, in addition to medical issues, that contributed to
the 455 percent increase in cesarean sections between 1965 and 1987.
“I think it’s important for everyone
to understand – both patients making medical decisions and doctors
making medical decisions – that medicine is not always a
dispassionate science. Social and cultural ingredients, as well as
evidence-based factors, contribute to medical decision making, and
that’s especially true of a specialty like obstetrics which speaks
daily to so many of our individual and societal hopes and concerns,”
says Wolf.
“A Social History of Cesarean Section in the United States”
will examine a medical procedure that has long been a cause of
controversy, and Wolf hopes her book, which she plans to complete by
the end of the three-year grant period, will help shape the national
conversation about the efficacy of the current 32.9 percent cesarean
section rate.
While obstetricians have pointed to
the threat of malpractice suits as the primary cause of the increase
in cesarean births, Wolf will investigate additional contributors to
the rise such as the effect of the Apgar score on attitudes toward
birth, the widespread use of the electronic fetal monitor, changes
in the medical and public perception of risk, the increasing number
of working mothers of infants, and the influence of female
obstetricians.
Data for the book, which will be the
first history of cesarean section in the 19th and early
20th century United States, will be culled from extensive
archival research, including obstetric logs, the papers of birth
reform organizations, physicians’ personal papers, and women’s
letters and diaries as well as oral history interviews with women
who have given birth by cesarean and physicians who have performed
cesareans. The study will not only be a historical view of cesarean
section as a medical procedure, but also of the cultural values that
shape attitudes toward the body, medical treatment, and our
perceptions of what constitutes a health risk.
Wolf’s previous research focused on
breastfeeding and birth practices. In 2009, Johns Hopkins University
Press published her second book, Deliver Me from Pain: Anesthesia
and Birth in America, an examination of changing views of labor
pain and the use of obstetric anesthesia from 1847 to the present.
The last chapter of the book looked at procedures characterizing
contemporary birth, including epidural anesthesia and birth by
cesarean section, sparking Wolf’s interest in more closely examining
historical aspects of births b
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