A rhetorical analysis of obstetric recommendations on vaginal birth after a previous cesarean delivery
The social construction of illness was first conceptualized in the field of psychology. Since that time researchers have described many areas of health where illnesses have been socially or culturally produced; once such area is pregnancy and childbirth. Pregnancy and childbirth have historically been physiological processes accomplished with little or no assistance. Advances in medicine and technology led physicians to take control of the pregnancy process and frame it as a medical condition. Framing pregnancy and delivery as a medical condition allowed physicians to implement interventions and create new medical conditions. By utilizing the medical intervention of cesarean sections, physicians have necessitated the creation of a new procedure, vaginal birth after a previous cesarean delivery (VBAC). VBAC has been shaped and controlled by the medical community through the use of practice guidelines. The most widely utilized guidelines on VBAC are issued by the American College of Obstetrics and Gynecology (ACOG). ACOG guidelines on VBAC are considered the industry standard, and thus have more influence on physician practice patterns and patient care than guidelines issued by other agencies. This paper utilizes a rhetorical lens to analyze the communications on VBAC issued by ACOG to obstetricians. This analysis identifies changes to the reports tone, purpose and contents over time, as well as the resulting impact on the care that patients may or may not receive. ^
George H. Avery, Purdue University.
Health Sciences, Obstetrics and Gynecology|Health Sciences, Public Health