ABSTRACT
Nurse-midwives both reinforce and subvert American constructs of gender roles. They do this both within the context of their relationship with the medical establishment and within the context of their relationship with women and families they serve. The authors explore this paradox through an examination of American society's historical and present constructs of gender role, the ways in which the medical profession has absorbed and prescribed these constructs, the effect of these constructs on medical and nurse-midwifery childbirth management of care, and, within the contextual framework thus established, the role of nurse-midwives in reinforcing and subverting traditional gender role constructs. Finally, the impact of this paradox on the provision of nurse-midwifery care to women and families is explored.