Description and Official Rationale
When a laboring woman walks into a hospital, one of the first things that happens to her is that she will be asked or told to sit in a wheelchair, in which she will then be wheeled to the "prep" room, instead of walking. The rationale behind this procedure is that the woman might faint or stumble, and fall, hurting either herself or her baby, and making the hospital vulnerable to lawsuits.
Physiological Effects
The primary effects of a brief ride in a wheelchair will be cognitive, not physiological.
Women's Responses
Most laboring women feel that they are perfectly capable of walking and are no more likely to fall during labor than before it began. Some report enjoying the ride, whereas others dislike being made to feel silly and weak. Some women accept the message sent to them by the wheelchair, whereas others invert its symbolism, and so avoid internalizing its message:
I can remember just almost being in tears by the way they would wheel you in. I would come to the delivery or into the hospital on top of this, breathing, you know, all in control. And they slap you in this wheelchair! It made me suddenly feel like maybe I wasn't in control anymore.
-Suzanne Sampson The maternity room sent somebody down with a wheelchair. I didn't have any need for a wheelchair so we piled all of the luggage up in the wheelchair and wheeled it up to the floor.
-Patricia Hellman
As we have seen, under the technocratic model labor is viewed as a mechanical process taking place inside a machine inherently predisposed to malfunction. It is thus incumbent upon the hospital to assume in its treatment of birth that malfunction may occur at any time and to be constantly prepared for its occurrence--an assumption that has led to what Suzanne Arms has called "just-in-case obstetrics" (Ettner 1976:38). It is also incumbent upon the hospital to make the premises of the technocratic model appear to be true, and to map the reality contained within this model onto the birthing woman's perceptions of her situation so skillfully that she will be able to perceive her experience in these terms only.
The wheelchair is an interesting first step in this process. To place a healthy woman in a wheelchair instead of allowing her to walk on her own is to tell her that at the very least the hospital thinks of her as disabled and weak. Although she may reject this message on a conscious intellectual level, its passage through her body and into the right hemisphere of her brain will guarantee that, on an unconscious level, she will receive the message, "you are disabled"; in other words, she will receive what one psychologist has called a "felt sense" (Gendlin 1982) of her body as suddenly weak and dependent, as in Suzanne Sampson's response above.
The cognitive ramifications of the wheelchair do not end with its effect on the laboring woman's perceptions of herself. Seeing his wife being pushed along in a wheelchair transforms her as well in the eyes of her partner, who may suddenly perceive her as weaker, more passive, and more fragile than before. Moreover, the first impression she makes on her hospital attendants will include the images of fragility, passivity, and disability, images on which their further assessments of her will be based. Her lowered position has the effect of making hospital personnel talk to the partner standing, while talking down to the laboring woman in the wheelchair. The image of disability will most especially include the image of inability to walk; from the moment of her entry into the labor and delivery unit, the laboring woman is marked as someone who should not or cannot walk (a significant message, since walking is one of the most beneficial things a woman in labor can do--as is discussed later in this chapter). As in any initiatory rite of passage, this estranging or "strange-making" device is employed at the very beginning; the effect is to start the breakdown of the initiate's category system necessary to ensure her openness to new learning.