Four Meanings of Medicalization: Childbirth as a Case study - Medicalisation is a commonly used and ‘easily’ understood concept among health care providers and researchers as well as in popular culture, but it is contested within medical sociology. This paper distinguishes between four meanings bestowed on medicalisation to enhance its conceptual clarity, using the example of childbirth as an illustration. Within the first generation of medicalisation theory, largely covering the ideas of Freidson, Conrad and Illich, we distinguish between three layers of meaning: (a) the origin of the medical model; (b) medical imperialism; and (c) iatrogenesis. The first meaning refers to the origin of the medical knowledge. In the second meaning daily life becomes increasingly defined in terms of health and illness, hence incorporating a growing number of life domains and social problems. The power of the medical discourse and the associated social control are central issues. The third meaning is represented by the critical or conflict sociological approach, in which medicalisation is interpreted as an exaggeration of medical control, hence emphasising its iatrogenic (‘sick-making’) effects. The second generation medicalisation theory addresses a changed and more complex organisation of health care. New medicalisation tendencies surpass the old ones, adding a new layer of meanings to the concept: the optimalisation of normal characteristics or processes. Hence, normal phenomena become problematic and a new consuming market is created. A key message from our paper is that poor conceptualisation of medicalisation as an analytical tool endangers the quality and comparability of social scientific research and interdisciplinary collaboration.
Keywords: medicalization, birth, iatrogenesis, medical imperialism, sociology of health, health care.
Parole chiave: medicalizzazione, parto, iatrogenesi, imperialismo medico, sociologia della salute, assistenza sanitaria.