xiii, 307 p. / The midwifery model and the medical model constitute the two main bodies of knowledge and practice that characterize the way pregnancy and birth are viewed in the United States. The midwifery model emphasizes the normalcy of pregnancy and birth, while the medical model is characterized by a belief in the supremacy of technology over nature and in medical supervision and intervention during pregnancy and delivery. Although both models do espouse important information regarding pregnancy and birth and, at times, there is overlap in the practical application of the models, practitioners of the two models rarely interact with one another. The one situation where practitioners of these two models do come into contact is during home-to-hospital transports for planned home births. Through in-depth interviews with direct-entry midwives, mothers, obstetricians, and nurses, this dissertation explores what happens when practitioners of the two models are forced to interact during home-to-hospital transports in order to provide care for women and their babies. Building on Davis-Floyd's and Johnson and Davis-Floyd's work on home-to-hospital transport, interview data suggest that a series of professional and organizational level factors influence the interactions between obstetricians, direct-entry midwives, and nurses during transports. Findings indicate that care providers engage in emotion work as they navigate the disjuncture between home and hospital, managing their own feelings and the feelings of others during a home-to-hospital transport. Due to the lack of institutionalized protocols governing conduct during transports, practitioners of the two models of care are left to construct their own versions of protocols through micro-level interactions, which at particular times and among certain providers have the effect of transcending the boundaries that divide home and hospital. With the interaction that occurs during a home-to-hospital transport as the central focus, this dissertation provides insight into how the lack of integration between the more marginalized midwifery model and the dominant medical model of care in the U.S. affects care providers and laboring/birthing women during transport situations. / Committee in charge: Jocelyn Hollander, Chairperson; Yvonne Braun, Member; Linda Fuller, Member; Carol Stabile, Outside Member; Melissa Cheyney, Non-UO Member

The study attempted to identify factors influencing women’s preference for home births in the Mutare District, Zimbabwe. A quantitative, descriptive, exploratory, cross sectional survey, gathering data by conducting structured interviews with 150 women, was used. All 150 women attended antenatal clinics but did not deliver their babies at health care facilities. The research results indicated that home deliveries might decline if: • the hospital/clinic fees were reduced or removed • transport would be available for women in labour to reach hospitals/clinics • shelters were built for pregnant women at hospitals/clinics • clinics were well equipped and had sufficient numbers of midwives • women had received more effective health education on the advantages of institutional deliveries and on the danger signs of pregnancy/labour complications • nurses/midwives would treat patients respectfully. Unless these factors are addressed, the number of home deliveries might not decline, and the high maternal/infant mortality and morbidity rates in this district will persist. / Health Studies / M. Public Health

The study attempted to identify factors influencing women’s preference for home births in the Mutare District, Zimbabwe. A quantitative, descriptive, exploratory, cross sectional survey, gathering data by conducting structured interviews with 150 women, was used. All 150 women attended antenatal clinics but did not deliver their babies at health care facilities. The research results indicated that home deliveries might decline if: • the hospital/clinic fees were reduced or removed • transport would be available for women in labour to reach hospitals/clinics • shelters were built for pregnant women at hospitals/clinics • clinics were well equipped and had sufficient numbers of midwives • women had received more effective health education on the advantages of institutional deliveries and on the danger signs of pregnancy/labour complications • nurses/midwives would treat patients respectfully. Unless these factors are addressed, the number of home deliveries might not decline, and the high maternal/infant mortality and morbidity rates in this district will persist. / Health Studies / M. Public Health