Delivery of the infant in a "delivery room" seems necessary to obstetrical personnel, especially those in tertiary care centers, for a variety of reasons. These include the sterility of the environment, not achievable in the labor room, and the availability of bright lights and the full array of instruments. So when delivery is imminent, the laboring woman is wheeled down the hall from her labor room to the delivery room, where she is positioned on a high, flat table in the center of the room.

Physiological Effects

As is indicated in the women's responses below, the physiological effects of being moved when one is ready to push include increased stress and pain, not to mention the sheer physical effort of climbing on and off of tables with a baby about to emerge from one's body. Various animal studies have indicated that environmental disturbances have strongly detrimental effects on labor (Bleicher 1962; Freak 1962; Hafetz 1962; Newton et al. 1968; Newton 1973), including inhibition of maternal oxytocin production and subsequent labor slowing.

Women's Responses

Another thing that bugged the heck out of me is they would come in and here you were--and I was really in control. I had done all these things and was in control. And they'd say, all right, get over here on this bed. We want to take you to the delivery room. Jack would say, well, wait until she finishes this contraction."Get over here on this bed!" Now here I am in the middle of a contraction. Leave me alone! And you know, they'd start moving you, and moving the IV. They didn't even stand there and wait until it's over....Well, heavens. To crawl over on that metal table and wheel you down the hall and they'd get the IV, you know, and they'd take it and say "Get over here" and then you'd have to crawl over this cord. You know, why didn't they say...just hop on over here!

-July Sanders

Then I got in the delivery room and they said okay, get on the delivery table. Well, there was nobody there to--nobody offered to kind of help me get off the guerney onto the delivery table and I was having contractions, and quite a bit of discomfort, and I just thought gee, I would expect someone to kind of lift me up or something. I felt like I got on that table with my grit and fingernails. It was a real awkward kind of thing. And I realized too in that transition [to the delivery room] that with nobody to push and breathe with me during the contractions, that it was really hard. [My husband] was there, but I guess he may have been getting on his mask...or something like that.

-Constance O'Riley

Ritual Purposes

In Western biomedicine, the operating room constitutes the inner sanctum sanctorum--the technocratic equivalent of the Ndembu sacred shrine (a place where all the categories must be carefully kept, and where the presence of the other world is palpable). In the "O.R." the surgeon demonstrates his skill at manipulation of the human body-machine. From its inception, the obstetrical profession was constrained to justify itself as of equal medical value to other branches of medicine in which the inherent pathology of the disease or accident treated was perhaps clearer than is the "pathology" of normal birth (Wertz and Wertz 1989:145). Therefore, obstetrics' procedures had to parallel those of other, more immediately respected areas of medicine as closely as possible. Thus, although the normal deliveries performed in the delivery room hardly compare in terms of pathology to the climactic surgical emergencies handled in the operating room, because the birth of the baby was the climactic event of the labor process, conceptually speaking, it had to be performed in the delivery room--the obstetrical equivalent of the surgical O.R.

As such, and as the place where the laboring woman knows that, one way or another, her baby will finally be born, the delivery room carries for her a high emotional charge. Transportation to the delivery room thus increases the affectivity of the birth event for both mother and staff, an affectivity that is further increased by the strong element of drama established by the rapid intensification in the number of ritual actions performed upon the laboring woman's body immediately before and after she enters the holy of holies. In July's and Constance's descriptions above, we can observe how the woman herself, so carefully ushered up to the labor room in a wheelchair at the beginning when she could have walked, now has become fundamentally irrelevant to this process, as she is ordered about and ignored as the moment of birth approaches. While Constance was climbing onto the delivery table with her "grit and fingernails," all of the medical personnel in the room were busy getting ready for the birth. They each had a function, a specific job to do, but those functions did not include recognizing, celebrating, or honoring the woman as birth-giver.

Once established on the delivery table, and appropriately cleansed and draped, the birthing woman's genital region becomes the stage upon which the doctor-- supported by his cast and crew--directs, produces, and stars in the play of the baby's birth (Shaw 1974:84). And, in the manner of all dramatic rituals, every successful performance works to ensure that the play will continue to be produced.