ABSTRACT
The idea that health care should be left to competitive market forces presumes a good deal about the behavior of ordinary people; it presumes very little about institutional constraints on that behavior. Among educated working couples who are planning to have a child, hospital birth providing state-of-the-art technological backup is a hedge against potential catastrophes, especially to the vulnerable infant. The protective sentiments of parents are a major dynamic in promoting childbirth technologies. Medical investment in childbirth technologies has resulted in the remarkable invention of a new patient, the neonate. The recognition that mothers and newborns are potential consumers of advanced hospital technology is best evidenced in the growth of regional centers that coordinate childbirth technologies. The increased use of childbirth technologies relies on their emergency care emphasis. If the heavy investment in costly childbirth technologies continues, the two-tiered system emerging will not decrease rates of premature births.
