Marginalized women's comparisons of their hospital and freestanding birth center experiences: a contrast of inner-city birthing systems.

The process of birth provides a structure around which social and cultural forces guide its expression. These social and cultural forces reflect the organization of power in a society while creating the potential for diversity in birth beliefs, practices, and experiences. In this article, marginalized women contrast their experiences in the cultures of two divergent birth systems: the technocratic hospital system and a freestanding midwifery managed birth center system. The women in this study come from many different cultures, yet they share a common desire to (a) control the birth environment, (b) establish supportive interpersonal connections with providers, (c) have a safe birth, and (d) be treated with dignity and respect. However, the descriptions in this article illustrate the gender, race, and class power inequities experienced when technocratic cultural forces conflicted with oppressed women's basic needs for respect and control.