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Purpose – This chapter briefly outlines the history of childbirth in the United States and describes the influence of the natural birth movement and consumer demand in shaping the contemporary advertising of mainstream maternity services.

Design/methodology/approach – Qualitative content analysis of 59 hospital websites was undertaken in order to understand how hospitals depict childbirth in their online advertising.

Findings – Our findings illustrate how contemporary medical institutions idealize childbirth through their depictions of its physical and social dimensions. Although hospital advertising has adopted some of the rhetoric of the natural birth movement in describing the social and symbolic dimensions of the childbirth experience, this rhetoric is shown to stand in tension to the highly rationalized and bureaucratic institutional nature of hospitals. These tensions are most apparent in advertised descriptions of the physical environment of maternity centers and in the attempt to depict hospitalized birth as an opportunity for the individual empowerment of women.

Research limitations/implications – This research is limited to an analysis of how providers advertise their services and does not provide data on whether practices actually reflect the rhetoric of the ideal birth. Future research should consider the fit between rhetoric and reality in hospital maternity practices in order to better understand the social structural constraints of delivering these services in a hospital maternity center.

Originality/value – This chapter highlights the importance of consumer demand for how maternity services are portrayed and identifies key tensions between an idealized image of birth and the rational, bureaucratic demands of modern medical institutions.

Purpose – This chapter addresses the transformation of patient into consumer, focusing on the specific population of human egg recipients. This work also analyzes medicine, and reproductive medicine and egg donation specifically, as marketplaces, particularly as they function in the Internet environment.

Methodology – This chapter utilizes a content analysis of egg donation related websites using both inductive and deductive coding schemes.

Findings – Egg donation related websites and their practices do indeed fit the model of a reproductive medicine marketplace, particularly those practices related to marketing strategies and cost.

Originality/value – This work focuses on the Internet as a primary location for a reproductive medicine marketplace, and develops a new understanding of the ways in which consumers are transformed by and operate in this market. It also demonstrates the emerging need for policy to govern this marketplace.

Purpose – The goal of this chapter is to understand the role of nonprofit voluntary health organizations (VHOs) in the lives of Canadian women coping with breast cancer.

Methodology – Through qualitative interviews with breast cancer survivors and records of VHOs active in this field, we assess the level and nature of their interactions and impact on women's quality of life.

Findings – Our findings suggest that at the micro-level, VHOs are venues for women to receive auxiliary services such as information, counseling, and support that complement the mainstream health care provision. While VHO services empower women as health care consumers, we show that they also serve as venues for women to reciprocate by volunteering. This process of reciprocity helps women cope with their own healing and allows them to be not only consumers but also producers of health services.

Research limitations – The non-random nature and the small sample size make our findings not easily generalizable to the larger population of breast cancer survivors; rather they are indicative of the experiences of Canadian women in one large urban metropolitan area.

Value of the chapter – We demonstrate the role of VHOs as venues of health consumerism as well as places for consumers to become involved in the production of services by volunteering.

Purpose – This study seeks to answer the question of whether donations to the Dutch Heart Association are a form of solidarity of the healthy with the sick. In doing so, I test hypotheses on the origins of charitable donations in awareness of need in conjunction with dispositional empathic concern, social networks and own health.

Methodology – I report probit, tobit and multinomial regression analyses on data from the Giving in the Netherlands Panel Survey (2002–2004; n=1,246) on donations to the Dutch Heart Association and other health charities.

Findings – I find that experience with cardiovascular diseases is associated with a higher likelihood of donating to the Dutch Heart Association, especially among those with higher levels of empathic concern and social responsibility, and among those who are not in excellent health themselves. Support for the Dutch Heart Association comes from those who are aware of the need for contributions and more easily imagine themselves in a situation similar to those of heart patients.

Research limitations/implications – The results confirm the role of empathic concern, explore the role of own health and seem to reject the role of ties to family members. The study is limited to the Dutch Heart Association. Future research should test whether these results can be generalized to donations to other charitable causes.

Originality/value of chapter – This study contributes to our knowledge on charitable donations, revealing new insights on the influence of awareness of need.

Purpose – This chapter critically examines the purportedly growing phenomenon of Maternal Request Caesarean Sections (MRCS) and its relative contribution to the rising caesarean section (CS) rates.

Methodology – We apply a decentred comparative methodological approach to this problem by drawing upon and comparatively examining empirical data from Canada, the US, the UK and Finland.

Findings – We find that the general argument that has emerged within the obstetric community, evidenced in particular by a recent “State of the Science” conference, is that the reduced risks and benefits of MRCS are evenly balanced, thus ethically it could be seen as a valid choice for women. This approach, taken in particular in the North American context, negates the problematic nature of accurately measuring, and therefore assessing the importance of maternal request in addressing rising CS rates. Moreover, although some of the blame for rising CS rates has focused on MRCS, we argue that it has a relatively minor influence on rising rates. We show instead how rising CS rates can more appropriately be attributed to obstetrical policies and practices.

Originality – In presenting this argument, we challenge some of the prevailing notions of consumerism in maternity care and its influence on the practice patterns of maternity care professionals.

Practical implications – Our argument also calls into question how successful efforts to address MRCS will be in reducing CS rates given its relatively minor influence.

Purpose – This study identifies the multiple contributions of the Salvadoran women's movement in sustaining mass mobilization under the threat of public health care privatization.

Methodology/approach – A case study methodological approach shows how the emergence of an autonomous women's movement in El Salvador in the late 1980s and early 1990s “spilled over” (Meyer & Whittier, 1994) to assist in the maintenance of the health care campaigns in the late 1990s and early 2000s.

Findings – We observed three arenas in which the women's movement played pivotal roles in the anti-health care privatization struggle: (1) women-based organizations; (2) leadership positions within larger coalitions brokering the participation of diverse social sectors; and (3) key advocacy roles inside the state. These three contributions of the women's movement increased the overall level of mobilization and success against health care privatization.

Research limitations – The study centered on one major group of health care consumers. The role of other civic organizations should be examined in future research.

Originality/value of chapter – The study demonstrates that in the era of globalization, women's movements form a critical part of the social movement sector facilitating the construction of large coalitions protecting consumers from neoliberal restructuring in areas such as public health care.

Purpose – This chapter examines the international Clubhouse movement, which features a unique “partnership model” that enables individuals who have serious and persistent mental illness to take an active role in their recovery. Consumer–provider and consumer–consumer supportive relationships are deepened through engagement in a range of cooperative activities both in the Clubhouse and in the local community.

Methodology – Data for this study have been gathered via case materials, semi-structured interviews, review of official publications, direct experience, participant observation, primary and secondary sources.

Findings – This study is consistent with other research demonstrating the efficacy of the Clubhouse model in providing mental health consumer assistance and support to gain paid employment, an education, and adequate housing.

Research limitations – While data have been gathered from a variety of sources encompassing a large number of Clubhouses, this is a single case study that includes limited comparative analysis with other modalities.

Practical implications – The Clubhouse model is an option that shows great promise for assisting mental health consumers to obtain employment, education, housing, and supportive relationships including peer support. It also promotes leadership development and participation in collective action for policy reform.

Originality/value – The Clubhouse approach is grounded in an empowerment paradigm of helping that emphasizes a strengths-based perspective, resiliency, activated consumers, collaborative partnerships with professionals, high expectations, self-help, mutual assistance, self-advocacy, and collective action for social change.