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.     

Book reviews

Transborder Data Flows (Proceedings of an OECD Conference) Edited by Hans‐Peter Gassmann North Holland (Elsevier Science Publishers) 1985, US$74.00

Plastic and Electronic Money: New Payment Systems and Their Implications Patrick Frazer Woodhead Faulkner Limited 1985 £35

A User's Guide To Computer Contracting: Forms, Techniques and Strategies Davis, Allen, Bowman and Armstrong Harcourt Brace Jovanovich 1985, $75

Legal Protection of Computer Programs and Data C. Millard Sweet & Maxwell/Stevens 1985, £24

Piracy of Phonograms Gillian Davies ESC Publishing Ltd. 1986. 2nd edition. £17.95.

Biotechnology and Patent Protection—An International Review F. K. Beier, R. S. Crespi and J. Straus O.E.C.D. 1985, £5

Protecting Privacy in Two‐Way Electronic Services David H. Flaherty Mansell Publishing Company 1985, £23.50

High‐Tech Espionage Jay Tuck Sidgwick and Jackson Ltd 1980, £10.95     

Multiple deaths from argon contamination of hospital oxygen supply

During the course of routine hospital surgical procedures, three patients lapsed into hypoxic cyanosis. Two expired immediately, another after four days of coma. Investigation of the hospital's central liquid oxygen tank revealed that it had been refilled recently and was labelled both "oxygen" and "argon." Mass spectrometric analysis of gas sampled from the questioned tank revealed a predominance of argon. A discussion of the sampling technique, method of analysis, role of the criminalist, and causes of this accident is presented.     

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.     

Tumbling abrasions. Injuries from ricocheting bullets

Atypical entrance gunshot wounds may be produced by deflected or ricocheting bullets. One special type of atypical entrance wound involves abrasion of the skin at a site that is remote from the point of dermal penetration. These remote abrasions, termed "tumbling abrasions," are produced by bullets that tumble after impact with an intermediate target. Three cases of tumbling abrasions are presented.