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 19^th and early 20^th 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 by cesarean section.