Moreover, in spite of the increasing availability of various options, and of nearly three decades of effort by childbirth activists to change them, the procedures analyzed below are all still standard in many American hospitals; they were all experienced by the majority of the women in my study. Together they paint a composite picture of American core values and beliefs. I argue that these procedures serve as rituals and are so widely used in hospital birth because they successfully fulfill several important needs:

(1) the individual psychological needs of the hospital personnel officially responsible for birth for constant confirmation of the rightness of the technocratic model, and for reassuring ways to cope with birth's constant threat to upset that model; (2) the individual needs of birthing women for psychological reassurance in the face of these same unknowns, for official recognition by society of their personal transformations, and for official confirmation of the rightness and validity of their belief systems; and (3) the need of the wider culture to ensure the effective socialization of its citizens and thus its own perpetuation.