 Lyerly (2006) argues that the problem with modern birthing practices is not the use of technology or the lack of it per se, for technology itself has no inherent meaning or import. Rather, the problem lies in a culture of birth that is expert-centered rather than patient-centered. She draws on phenomenological work by Sandra Bartky in order to show how “female shame is reinforced by dominant strains of birthing practice—both hospital-based obstetrics and midwifery” (Ibid, 103). She writes, “Analyses that focus on models of birthing rather than women's emotional lives fail to capture the substance of the insult that women have recently incurred in giving birth. In holding technology culpable, these analyses are not only inaccurate but also threaten to disenfranchise women for whom sensitively applied medical practices can enhance both the safety and agency so important to a good birth” (Ibid, p. 117). When misused, technology can subjugate women to medical authority, undercut their sense of dignity and control, and alienate them from the birth process. But it can also be used to enhance women's agency (such as when pain medication enables a woman to maintain her dignity and presence of mind at her birth, or when a scheduled cesarean allows a woman to feel confident that she will have her partner who is about to deploy overseas present at her birth). Meanwhile, a relatively ‘natural’ birth that does not get caught up in a cascade of medical interventions can be empowering. But natural childbirth advocates often paint an idealized picture of how birth is supposed to proceed (see also Crossley 2007), and treat ‘success’ at natural childbirth as a mark of maternal character (see also Kukla 2008). Women who for various reasons—including pre-existing medical conditions or various complications during labor—do not manage to have a vaginal delivery free of pain medication and medical intervention may feel that they have ‘failed’ to give birth properly.