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The extraordinary social and economic impact of the COVID-19 pandemic has generated many claims about the middle-range future-the period beginning in the late summer or early fall of 2020 and projected to last for some months or years This paper surveys those assertions and seeks to explain the factors that led to them Exploring questions about future claims can expand the scope of social problems theory

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.

Social meanings and cultural definitions attached to illness, disability, and aging have a powerful influence on the development and operations of medical care as well as the social, behavioral, and therapeutic processes occurring within these settings. Specialized care environments designed to meet the needs of what some would argue is a dramatically increasing population worldwide, those with Alzheimer's disease, have been dominated by a medical model of care where treatment of disease has primacy over person. In contrast to the medical model, the Certified Nursing Assistants (CNAs) at Starrmount (pseudonym) Alzheimer's Unit have socially constructed an alternative to the medical model of care through what I argue is the use of language and a process of “naming and reframing.” In this “different world,” as the CNAs call the world of the Unit, the resident is depicted as a socially responsive actor with a surviving self that is to be treated with respect. Using a symbolic interactionist framework, this paper examines the CNAs' construction and use of a “language of openings”—that is, the language arising out of the lifeworld of the residents—as the counterpoint to the “language of limits” of the medical model. Spoken everywhere but nowhere inscribed as “official” knowledge, this “little language,” as the CNAs speak of it, is the fundamental medium for social interaction in the Alzheimer's Unit.