Book ID: CBB871642225

Pushing in Silence: Modernizing Puerto Rico and the Medicalization of Childbirth (2017)


Cordova, Isabel M. (Author)

University of Texas Press

Publication Date: 2017
Physical Details: 248 pp.
Language: English

As Puerto Rico rapidly industrialized from the late 1940s until the 1970s, the social, political, and economic landscape changed profoundly. In the realm of heath care, the development of medical education, new medical technologies, and a new faith in science radically redefined childbirth and its practice. What had traditionally been a home-based, family-oriented process, assisted by women and midwives and "accomplished" by mothers, became a medicalized, hospital-based procedure, "accomplished" and directed by biomedical, predominantly male, practitioners, and, ultimately reconfigured, after the 1980s, into a technocratic model of childbirth, driven by doctors' fears of malpractice suits and hospitals' corporate concerns.Pushing in Silence charts the medicalization of childbirth in Puerto Rico and demonstrates how biomedicine is culturally constructed within regional and historical contexts. Prior to 1950, registered midwives on the island outnumbered registered doctors by two to one, and they attended well over half of all deliveries. Isabel M. Córdova traces how, over the next quarter-century, midwifery almost completely disappeared as state programs led by scientifically trained experts and organized by bureaucratic institutions restructured and formalized birthing practices. Only after cesarean rates skyrocketed in the 1980s and 1990s did midwifery make a modest return through the practices of five newly trained midwives. This history, which mirrors similar patterns in the United States and elsewhere, adds an important new chapter to the development of medicine and technology in Latin America.

Reviewed By

Review Cassia Roth (2022) Review of "Pushing in Silence: Modernizing Puerto Rico and the Medicalization of Childbirth". Journal of American History (pp. 471-472). unapi

Review Katherine E. Bliss (2019) Review of "Pushing in Silence: Modernizing Puerto Rico and the Medicalization of Childbirth". American Historical Review (pp. 1478-1479). unapi

Review Linda C Magaña (2019) Review of "Pushing in Silence: Modernizing Puerto Rico and the Medicalization of Childbirth". Social History of Medicine (pp. 207-208). unapi

Review Laura Briggs (2018) Review of "Pushing in Silence: Modernizing Puerto Rico and the Medicalization of Childbirth". Bulletin of the History of Medicine (pp. 706-707). unapi

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Authors & Contributors
Cicatiello, Clotilde
Allison, Julia
Robilliard, Gabrielle
King, Laura
Martín-Alcaide, Rosario
Foscati, Alessandra
Social History of Medicine
Women's History Review
Medical History
Llull: Revista de la Sociedad Española de Historia de las Ciencias y de las Técnicas
História, Ciências, Saúde---Manguinhos
Canadian Bulletin of Medical History/Bulletin Canadienne d'Histoire de la Medecine
Vanderbilt University Press
Oxford University Press
Johns Hopkins University Press
Obstetrics and pregnancy
Physicians; doctors
Professions and professionalization
Time Periods
20th century
19th century
Early modern
16th century
Meiji period (Japan, 1868-1910)
Edo period (Japan, 1603-1868)
United States
Great Britain
Southern states (U.S.)
Bahia (Brazil)

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