Community midwifery and state measures: the new midwifery in British Columbia

The New Midwifery, a form of community midwifery rooted in home birth and intensive prenatal and postnatal care, has attracted great controversy since its appearance in British Columbia in the early 1970s. On the one hand, this form of community midwifery has endured despite legal prohibition. Midwives derive an income from their practices, obtain necessary supplies and equipment, and are active in lobbying for recognition through the State. On the other hand, community midwifery is marginalized and illegal. Out-of-hospital births comprise less than one percent of births in British Columbia (and nationwide). Community midwives are excluded from the provincal Medical Services Plan and they lack hospital privileges if their clients are transferred to hospital. Community midwives are more likely than medical personnel to be tried for criminal negligence causing death and subject to prosecution under theMedical Practitioners Act of practicing medicine without a license.Community midwifery illustrates the structural limits placed on female birth attendants working outside the norm of professionally accredited, hospital situated childbirth. It is concluded that State measures in Canada structure power relations in a dialectical fashion. This includes measures to consolidate the monopoly status of the medical profession and the nursing profession, while temporizing about demands for independent midwifery practice. State powers are however relatively autonomous of dominant economic groups such as the Medical profession. Not all prosecutions of community midwives are successful, and contradictions in State policies surrounding monopolistic powers and civil liberties, and gender relations are evident.An earlier version of this paper was presented at the Canadian Sociology and Anthropology Association Meetings, University of Manitoba, June 1986. The author is grateful for resources provided through the Social Sciences and Humanities Research Council of Canada, the Department of Anthropology and Sociology (University of British Columbia), and the School of Criminology, Simon Fraser University. Comments from Carol Bullock, Nanette Davis, Bob Ratner, Livy Visano and the Journal referees have been helpful in revising this paper.     

Deaths allegedly caused by the use of "choke holds" (shime-waza)

Shime-waza or the "choke hold", when properly applied, should not cause death; therefore, its primary purpose should be to subdue violent suspects. When properly applied, the choke hold causes unconsciousness in 10 to 20 s. No fatalities as a result of shime-waza have been reported in the sport of judo since its inception in 1882. Among the methods of "control holds" taught to law enforcement officers is the choke hold similar or identical to shime-waza used in judo. Using the choke hold, officers may afford themselves maximum safety while subjecting the suspect to a minimum possibility of injury. The author has reviewed 14 fatalities with autopsy findings where death was allegedly caused by the use of choke holds.     

Reviews

Terry Cox and Gary Littlejohn, eds., Kritsman and the Agrarian Marxists. (Library of Peasant Studies, No. 7), London: Frank Cass & Co. Ltd., 1984, 149 pp., £18.50.

S. G. Wheatcroft and R. W. Davies eds., Materials for a balance of the Soviet national economy 1928–1930 (with foreword by Richard Stone). Cambridge: Cambridge University Press, 1985, xxiv + 467 pp., £35.00, $59.50.

I. Birman, Ekonomika nedostach. New York: Chalidze Publications, 1983, 470 pp.

Richard F. Staar, USSR Foreign Policies After Detente. Stanford, Ca: Hoover Institution Press, 1985, xxvii + 300 pp., h/b $26.95, p/b $10.95.

John J. Maresca, To Helsinki: The Conference on Security and Cooperation in Europe 1973–1975. Durham, North Carolina: Duke University Press, 1985, xiii + 292 pp., £47.50.

Mark V. Kauppi and R. Craig Nation eds., The Soviet Union and the Middle East in the 1980s. Lexington, Mass, and Toronto: Lexington Books, D.C. Heath and Company, 1983, ix + 293 pp., £25.00.

Jonathan Haslam, The Soviet Union and the Struggle for Collective Security in Europe, 1933–1939. New York: St. Martin's, 1984, xii + 310 pp., $29.95.

Alfred L. Monks, Soviet Military Doctrine: 1960 to the Present. New York: Irvington Publishers, 1985, xii + 351 pp., $34.50.

Jeffrey D. Boutwell, Paul Doty, and Gregory F. Treverton eds., The Nuclear Confrontation in Europe. London: Croom Helm, 1985, 247 pp., £22.50.

Condoleezza Rice, The Soviet Union and the Czechoslovak Army, 1948–1983: Uncertain Allegiance. Princeton, N.J.: Princeton University Press, 1984, xiv + 303 pp. Tables. £40.40.

Vitaly Rapoport and Yuri Alexeev, High Treason: Essays on the History of the Red Army, 1918–1938. Translated by Bruce Adams. Durham: Duke University Press, 1985, xvii + 436 pp., £35.00.

Robert Conquest, Inside Stalin's Secret Police. NKVD Politics 1936–1939. Stanford, California: Hoover Institution Press, 1985, ix + 222 pp., $22.95.

Jeffrey T. Richelson, Sword and Shield. The Soviet Intelligence and Security Apparatus. Cambridge, Massachusetts: Ballinger Publishing Company, 1986, xix + 279 pp., $39.95 h/b, $16.95 p/b.

P. Marer, Dollar GNPs of the USSR and Eastern Europe. The Johns Hopkins University Press, Baltimore and London: For the World Bank. 1985, xiii + 241 pp., £20.00.

Moshe Lewin, The Making of the Soviet System: Essays in the Social History of Interwar Russia. London: Methuen, 1985, viii + 354 pp., £19.00 h/b, £8.95 p/b.

Eric P. Hoffmann and Robbin F. Laird, Technocratic Socialism: the Soviet Union in the Advanced Industrial Era. Durham: Duke University Press, 1985, viii + 228 pp. h/b £37.50, p/b £12.50.

Robert Cassen ed., Soviet Interests in the Third World. London: Sage Publications, 1985, xi + 329 pp., h/b £27.50, p/b £10.50.

Václav Havel et al., The Power of the Powerless: Citizens Against the State in Central‐Eastern Europe, Ed. John Keane, Introduction by Steven Lukes. London, Melbourne, Sydney, Auckland, Johannesburg: Hutchinson, 1985, 228 pp., £16.95.

Michael M. Boll, Cold War in the Balkans: American Foreign Policy and the Emergence of Communist Bulgaria, 1943–1947. Lexington, Ky.: The University Press of Kentucky, 1984, ix + 250 pp., £27.50.

Edward R. Girardet, Afghanistan: The Soviet War. London: Croom Helm, 1985, 259 pp., £17.95.

Henry S. Bradsher, Afghanistan and the Soviet Union. Durham: Duke University Press, 1985, viii + 384 pp., £12.95.

David W. Lovell, Trotsky's Analysis of Soviet Bureaucratization. London: Croom Helm, 1985, ix + 82 pp., £7.95.

Katerina Clark and Michael Holquist, Mikhail Bakhtin. Cambridge, Mass, and London: Harvard University Press, 1984, xi + 398 pp., £19.95.

Hans‐Georg Heinrich, Hungary. Politics, Economics and Society. London: Frances Pinter, 1986, xviii + 198 pp., £17.50.

Henry Rollet, La Pologne au XX^e Siècle. Paris: éditions A. Pedone, 1985, 603 pp., 240F.

Mieczyslaw F. Rakowski, Ein schwieriger Dialog. Aufzeichnungen zu Ereignissen in Polen 1981–1984. Mit einem Vorwort von Peter Bender. Econ Verlag. Düsseldorf‐Wien 1985. 269 pp. Index. DM. 38,00.

John Ambler, Denis J. B. Shaw and Leslie Symons eds., Soviet and East European Transport Problems. London and Sydney: Croom Helm, 1985, xix + 260 pp., £19.95.

Joan de Bardeleben, The Environment and Marxism‐Leninism: The Soviet and East German Experience. Boulder and London: Westview Press, 1985, xi + 338 pp., no price quoted.

John R. Lampe, The Bulgarian Economy in the Twentieth Century. London: Croom Helm, 1986 x + 245 pp., £25.00.

Pedro Ramet, Nationalism and Federalism in Yugoslavia, 1963–1983. Bloomington: Indiana University Press, 1984, xviii + 299 pp., $27.50.

Boris Meissner, Partei, Staat und Nation in der Sowjetunion. Ausgewdhlte Beitrage. Berlin: Duncker & Humblot, 1985, 544 pp., DM148.00.

Jiri Hochman, The Soviet Union and the Failure of Collective Security, 1934–1938. Cornell Studies in Security Affairs. Ithaca and London: Cornell University Press, 1984. 253 pp. $32.95.     

Marfan syndrome. A contribution to forensic medicine cases

A 19-year-old school boy suffered from fluctuating uncharacteristic chest pain in the last 20 h before his death. He died unexpectedly within a few minutes of a hemopericardium, which resulted from an aneurysmal rupture of the ascending aorta. The patient's past history as well as the autopsy and ultrastructural findings led to the diagnosis of Marfan's syndrome with alterations of the cardiovascular skeletal system but no ophthalmological involvement ("oligosymptomatic" form of Marfan's syndrome). Appraisal of the cause of death is made more difficult by the fact that medical treatment was undertaken on the same day, whereby subtotal liver crushing was established that had resulted from attempts at resuscitation.     

Legislative and educational alternatives to a judicial remedy for the transfer trauma dilemma

Transfer trauma is alleged to be an increase in morbidity and mortality in institutionally relocated chronically ill elderly. Efforts by the legal profession to persuade courts that transfer trauma should be a legally recognized phenomenon invoking judicial protections against transfer (the "transfer trauma argument") have been unproductive. In O'Bannon v. Town Court Nursing Center, Inc., the United States Supreme Court denied standing to elderly persons claiming a property interest in remaining in alleged substandard facilities. The Court rejected the argument that the possibility of transfer trauma constituted a deprivation of life or liberty that would have required due process protections of notice and hearing. Despite the Court's preclusion of transfer trauma litigation in a constitutional context and the general unwillingness of lower courts to recognize the phenomenon, attorneys continue to burden the judicial system with frivolous transfer trauma arguments. The unfruitful pursuit of a judicial remedy for the ethical and social problems that arise with relocation of the elderly continues, in part, because of a misguided belief that this distressing social phenomenon is best remedied by the courts. Judicial unwillingness to recognize the transfer trauma argument, however, does not preclude legislative consideration of the humanitarian issues concerning the institutional relocation of elderly persons. This Article examines gerontological research in order to understand the judicial rejection of the transfer trauma argument and argues in support of legislative and educational solutions for the ethical and social problems attending transfer.