The Pennsylvania State University The Graduate School College of Agricultural Sciences PUBLIC CULTURE, PRIVATE BIRTH: SOCIAL PATTERNS OF AMISH DOMESTIC SPACE A Thesis in Rural Sociology and Women’s Studies by Natalie Jolly © 2007 Natalie Jolly Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy August 2007 The thesis of Natalie Jolly was reviewed and approved* by the following: Carolyn Sachs Professor of Agricultural Economics and Rural Sociology Professor of Women’s Studies Thesis Adviser Chair of Committee Stephen Smith Department Head, Agricultural Economics and Rural Sociology Richard Stedman Associate Professor of Agricultural Economics and Rural Sociology Leland Glenna Assistant Professor of Agricultural Economics and Rural Sociology Lorraine Dowler Associate Professor of Geography Associate Professor of Women’s Studies Head of the Department of Women’s Studies Stephanie Springgay Assistant Professor of Art Education Assistant Professor of Women’s Studies *Signatures are on file in the Graduate School. ii Abstract In this dissertation research project I argue that birth plays a significant role in the lives of Amish women and men. And though birth has long been understood as merely a biological process, my research demonstrates that it is also a significant feature in the landscape of a society. This analy- sis of birth in several Pennsylvania Amish communities yields knowledge about both the particularities of Amish women’s birth experiences as well as the sociocultural significance of birth within the larger Amish community. Aspects of the domestic realm, such as birth, continue to be overlooked in sociological analyses because of their location in the private sphere. Instead of lack- ing sociological relevance, these personal matters hold the key to unlock a more nuanced understanding of communities and of society more generally. It is unlikely that sociological findings of consequence will be generated without an appreciation of the relationship between the public and private spheres – this has certainly been the case for the scholarship on the Amish. It is only with a careful attention to the interwoven relationship between the public and the private that we will be able to produce research that approaches the level of complexity and intricacy inherent in society today. iii Table of Contents Chapter 1: An Introduction to the Dissertation 1 Introduction 1 Undertaking a research project on birth 1 Research questions 3 An introduction to the study region 4 Chapter overviews 5 Chapter 2: An Ethnographic Inquiry 8 Introduction 8 The study: An Overview of the dissertation research project 9 Becoming a participant-observer 10 The research participants 12 The ethnographic structure 13 Conducting research 14 Data analysis 16 Feminist concerns with ethnographic research 17 On the possibility of writing an Amish ethnography 21 In conclusion 24 Chapter 3: The landscape of Amish society 25 Introduction 25 A discussion of Amish society 26 The structure of Amish community: A theoretical investigation 28 Research on the Amish: trends and reflections 32 Feminist critiques of Conventional Research: The missing Amish women 35 Current scholarship on Amish women: A review of the literature 38 Chapter 4: Birth and Amish Embodiment 41 Introduction 41 A Composite Sketch of an Amish Birth 41 A sociology of birth 43 Shame and the female body 44 Feminist theories of agency 48 The Interdiscourse of Amish birth 49 Chapter 5: The Role of the Midwife in Amish Society 53 Introduction 53 Community power 54 Midwife as a source of community power 55 The role of the midwife in Amish society 56 The non-Amish midwife in the Amish community 57 Midwives on the boundaries of Amish society 60 Shifting locations of community power 62 Chapter 6: Amish Identity and the Domestic Spaces of Daily Life 64 Introduction 64 The public/private dichotomy 65 The Amish public sphere 66 Critiquing the Public/Public Dichotomy 68 The Amish private sphere 69 Spaces of Amish domesticity 70 Chapter 7: Some Conclusions 75 Introduction 75 Dissertation Review 75 Reflections on the study 76 Limits of the study 78 Future research directions 79 Contributions to the literature 80 Works Cited 82 Chapter 1 An Introduction to the Dissertation Introduction Birth has long played a significant role in the lives of women and men. This event is not merely a private domestic experience shared within families, but is also an important cultural milestone that enables a deeper understanding of society. Insights into women’s birth experiences serve as a point of departure for a more general analysis of cultural patterns and social norms. And though we may suspect that birth is itself a biological event, birth practices are culturally specific and socially mediated in a variety of ways. Analyzing birth offers clues into the particular gender dynamics of a society as well as into the fluidity of social structures and hierarchies. As yet, there has been a dearth of scholarship that uses birth as a point of entry into sociological analyses, and this disserta- tion serves as an antidote to that trend. Because birth has been seen as a personal matter rather than an issue of public conse- quence, it has largely been omitted from academic inquiry. And while demographers have long focused on issues of fertility, birth rates and patterns of infant mortality, their work has not engaged with the sociocultural significance that birth has within certain communities. Like most matters per- ceived as domestic or private, birth is thought to lack sociological relevance and is rarely the focus of investigation. Feminists, however, have suggested that attention to these private realms offers evidence of how societies function and argue that analyses of the private sphere can enlighten both what we know about the ways that norms are constructed and enforced as well as the mechanisms through which norms become gendered. A close examination of the particularities of domestic spaces and the “private” events that occur there promises to augment our sociological imagination, as the public and private spheres are not diametrically opposed, but rather intertwined and mutually dependent – each are constituted from the other and exist in relation to one another. With a particular focus on Amish birth, I argue that the domestic lives of Amish women have remained an elusive topic despite the potential for offering insights into the nature of Amish soci- ety. Much conventional research has focused on the public realm of Amish life, and particular attention has been paid to the role of agriculture in the structure of Amish society and construction of Amish identity. A spotlight on the private realm supplements previous knowledge about the Amish. Using birth as a point of departure, I contend that the domestic spaces of Amish life hold the potential for both illuminating the particularities of Amish women’s daily lives as well as expand- ing our understanding of women’s role in Amish society more generally. Amish birth practices hold a social significance that is culturally specific and simultaneously generalizable far beyond the Ana- baptist communities from which they are born. Undertaking a research project on birth This research is juxtaposed against the context of birth in American (non-Amish) culture. Studying the Amish offers an interesting counterpoint to today’s increasingly medicalized birth climate and provides insight into the ways in which birth often reflects particular cultural patterns. Birth is a so- cial act, albeit one that has been largely overlooked by sociologists. Below I offer a brief analysis of American birth practices in order to offer some context on birth today. Though the Amish do exist within American society, their practices (particularly their birth practices) do not reflect the trend of today’s medicalized pattern of American birth. A review of current mainstream birth practices will 1 help illuminate the degree to which the Amish depart from America’s contemporary birth conven- tions. Birth in the United States has become increasingly medicalized, as evidenced by the grow- ing number of deliveries that are marked by high levels of obstetrical intervention and medical management (Kitzinger, 2005). Labors today are artificially induced, chemically intensified and increasingly end in surgical procedures (Wagner, 1997). And today, with the overall social consen- sus being that hospital birth is safest, this rising rate of obstetrical intervention is viewed as evidence of birth security. Particularly when attended by an obstetrician, a safe birth is seen as virtually guaranteed within the high-tech environment of the hospital delivery room. As a result, the vast majority of women continue to choose physician-attended (91.4%) or certified nurse midwife- attended (7.6%) hospital birth over other non-hospital alternatives (<1%). These statistics have remained relatively stable over recent decades. Today, over 99% of births take place in a hospital environment, and are subject to the procedures and treatments that accompany medicalized care (All statistics are taken from Martin et al., 2005). Most commonly, medical technologies are used to monitor the birthing woman and manage the delivery of the baby. It is routine practice for women to be constantly monitored through the use of an Electronic Fetal Monitor (EFM) (an instrument that measures the heartbeat of the baby) during the course of her labor (Lent, 1999). Over 85% of birthing women, or more than 3.2 million live births, were monitored during labor using EFM in 2003, and this rate has climbed steadily since 1989 (Martin et al., 2005). EFM is the most frequently reported obstetric procedure, and may in fact be used to monitor an even higher percentage of births. In addition to the EFM, it has become increasingly popular to employ Internal Fetal Monitoring (IFM) (where an electrode is attached through the vagina directly to the baby’s head) to ensure constant monitoring of the baby’s heart rate during labor.