ABSTRACT
Birth and birth technologies are important in all societies. Although professional expertise and new technologies are sought to improve the safety and comfort of birth for both mothers and children, these goals take on very different meanings in different societies and even between many groups in complex industrial societies. National health policies reflect larger societal values regarding social inequities. Policies vary enormously in the extent to which they perpetuate or seek to reduce inequities in life chances that vary by social class, race, and ethnicity during pregnancy, birth, and the neonatal period. In Western Europe and the Scandinavian countries that have socialized health-care systems and social policies designed to reduce social inequities, access and equity in birth-related services are dominant social and ethical issues. In the United States, dominated by fee-for-service medicine where services are rationed on the basis of ability to pay, the social and ethical issues surrounding birth that now receive the greatest attention are those embedded in a highly individualistic "health rights" model.
