Pathologising pregnancy

The consequences of medicalisation and the call for a balanced approach to perinatal care

Abstract

This article examines the pathologisation and over-medicalisation of pregnancy, arguing that pregnancy should not be classified as a disease. While medical interventions are essential in managing pregnancy-related complications, excessive medicalisation can undermine maternal autonomy and contribute to unnecessary interventions. We trace the historical shift from midwifery-led childbirth to obstetric control, highlighting how pregnancy came to be viewed as a clinical condition requiring constant medical oversight. Drawing on philosophical theories of disease, we analyse the debate surrounding pregnancy’s classification, considering naturalistic, normative, and pragmatic perspectives. Using focus group data from midwives, we provide concrete examples of over-medicalisation, including the routine overuse of procedures such as induction and episiotomy. We argue that a balanced approach is needed – one that acknowledges pregnancy’s physiological nature while ensuring access to medical care when appropriate. Avoiding both excessive medicalisation and rigid naturalisation can better support pregnant individuals’ well-being and decision-making autonomy.