Theoretical Background The great majority of literature related to the sociology of childbirth is based on pre-experimental design using one-shot interviews with primary care providers or their clients. Rothman (1983) attempts to understand the role of the home birth attendant through interviews with a cluster sample of twelve nurse-midwives practicing in the New York metropolitan area. She uses focused interview to assess their attitudes toward the management of the stages of labor. Rushing (1993) likewise employs a one-shot interviewing technique that explores the values of midwives, clients, and childbirth or midwifery activists. Rushing used a snowball sample of midwives, clients, and activists. By using a snowball sample she increases the probability that she will find like-minded individuals, which would not substantiate her attempt to identify general trends in ideology. Sakala (1993) combines a small meta-analysis of cesarean rate research with primary research consisting of in-depth, focused interviews with fifteen midwives to assess their attitudes and protocols related to indications for cesarean sections.
Sakala's primary research was derived from a geographic cluster sample. Therefore, the information gathered through these interviews have very little external validity and cannot be used to theorize generally about the attitudes, practices, and protocols of other groups of midwives.