This paper will describe birth as a social as well as a physiological event, a process which is socially constructed and socially defined. The ways in which the medical establishment controls the birth experience, creating it as a medical event, will be presented. The role of childbirth education is presented here as supporting the medical model and preparing the pregnant woman and her mate for their roles in the institutional birth. We will briefly consider an alternative, non-medical approach to birth. IF SITUATIONS DEFINED as real are real in their consequences, then those who define, control. Those who have the power to establish their definitions of a given situation as the working definition of reality control that situation. Obstetrics is the branch of medicine concerning the care of women during pregnancy, labor and the puerperium (Gould, 1972) and in contemporary American society has control over the definitions (or diagnoses) relevant to childbirth. Medical expansion into the area of childbirth began before the development of asepsis, surgical techniques, anesthesia. But by the beginning of the nineteenth century, medicine had begun the redefinition of childbirth from a family or religious event, to a medical event, needing medical presence for its safe conduct. (Bogdan, 1976). Until pregnancy and childbirth were defined as medical events, midwifery was in no sense an area, branch or interest of medicine as a profession. During the middle ages, midwifery and its concerns were outside of medicine. “One obvious group outside of the control of the university physician was the midwife, but during the period under study the university physician generally ignored this whole area of medicine. Midwives might or might not be qualified, but this was not a matter of public concern.” (Bullough, 1966: 102) Professions are political organizations, mandated by their relationship with the state, but within that mandate free to define the nature of their work and to work as they see fit. (Freidson and Lorber, 1972:3) When medicine expanded into obstetrics, it redefined childbirth in medical terms, removed from its socio-emotional context. Birth was redefined as “delivery,” not an activity which women engage in, but a procedure which doctors do, a service medicine can provide. When women as consumers of health care challenged that model, medicine reacted as challenged political organizations usually do, either discrediting or coopting its challengers. In the earlier period they saw midwives as “dirty,” unskilled. (c.f. Kobrin, 1966, Ehrenreich and English, 1973) Later on, segments of the reformists were brought out, given the role of “childbirth educators” and allowed to see themselves as “health professionals” and members of the “childbirth team.” Unlike the current home birth movement with a return to lay midwifery, the 1950’s “natural childbirth” movement’s simple desire that *An earlier version of this paper, “The Social Construction of Birth: A Symbolic Interactionist Analysis of In-Hospital, ‘Prepared’ Childbirth” was presented at the American Sociological Association meetings, Chicago, 1977.