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The Political “Nature” of Pregnancy and Childbirth

Published online by Cambridge University Press:  17 December 2008

Candace Johnson*
Affiliation:
University of Guelph
*
Candace Johnson, Department of Political Science, University of Guelph, 50 Stone Road East, Guelph, Ontario, CanadaN1G 2W1, cajohnso@uoguelph.ca

Abstract

Abstract. In this paper, I examine the theoretical debates concerning “medicalization” in relation to the empirical trend toward increased demand for “natural” options for childbirth. Many feminist theorists have argued that medical intervention in pregnancy and childbirth is both unwarranted and disempowering and devalues women's own abilities and experiences. Further, it is argued that medicalization (of seemingly natural events) is particularly damaging for women and other marginalized people. In this paper, I explore the claims (of both providers and consumers) concerning medical care for pregnancy and childbirth among privileged populations and ask why rejection of medical care for pregnancy and childbirth is not proportional to disadvantage. It appears to be the case that criticism of medical intervention in pregnancy and childbirth is strongest among privileged women and is expressed consistently as preference for “natural,” “traditional” or “normal” approaches and practices. Reverence for the natural, I argue, is a political claim that asserts social position, identity, and resistance. I consider this political claim to be embodied and demonstrated in the occurrence of a physical and psychic duality, a “split subjectivity,” that is exacerbated by the sharpness of the public-private divide in women's lives.

Résumé. Dans cet article, j'examine le débat théorique sur la médicalisation à la lumière de la vogue actuelle croissante des options plus naturelles pour l'accouchement. De nombreux auteurs féministes ont soutenu que les interventions médicales durant la grossesse et l'accouchement étaient injustifiées et qu'elles privaient les femmes de leur autonomie, tout en dévaluant leur expérience et leurs aptitudes naturelles. De même, la médicalisation (de phénomènes apparemment naturels) est, selon certains, particulièrement néfaste pour les femmes et les groupes marginalisés. Dans cet article, j'explore les affirmations (à la fois des prestataires et des bénéficiaires) concernant l'assistance médicale durant la grossesse et l'accouchement parmi les populations favorisées et je soulève la question de savoir pourquoi le rejet de l'assistance médicale durant la grossesse et l'accouchement n'est pas surtout le fait des milieux défavorisés. Il semble, en effet, que les critiques envers les interventions médicales durant la grossesse et l'accouchement proviennent surtout des femmes de milieux favoriséset que ces dernières manifestent de manière constante une préférence pour les approches et les pratiques «naturelles», «traditionnelles» ou «normales». La révérence envers le naturel est, selon moi, une revendication politique afin d'affirmer sa position sociale, son identité et sa résistance. Je considère que cette revendication politique est incarnée et démontrée par l'existence d'une dualité physique et psychique, une «subjectivité divisée» qui est exacerbée par l'acuité de la division entre le monde public et le monde privé dans la vie des femmes.

Type
Research Article
Copyright
Copyright © Canadian Political Science Association 2008

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References

Alberta Association of Midwives. 2007. http://www.albertamidwives.com/philosophy.htm (Dec. 18, 2007).Google Scholar
Appiah, K. Anthony. 1996. “Race, Culture, Identity: Misunderstood Connection.” In Colour Consciousness: The Political Morality of Race, ed. Appiah, K. Anthony and Gutmann, Amy. Princeton: Princeton University Press.Google Scholar
Association of Ontario Midwives. 2008. http://www.aom.on.ca (Jan. 21, 2008).Google Scholar
Bamiro, Edmund O. 1991. “The Social and Functional Power of Nigerian English.” World Englishes 10(3): 275–86.CrossRefGoogle Scholar
Beauvoir, Simone de. 1952. The Second Sex. London: Vintage Books.Google Scholar
Browne, Annette J. and Fiske, Joanne. 2001. “First Nation's Women's Encounters with Mainstream Health Care Services.” Western Journal of Nursing Research 23(2): 126–47.CrossRefGoogle ScholarPubMed
Cahill, Heather A. 2000. “Male Appropriation and Medicalization of Child Birth: An Historical Analysis: Philosophical and Ethical Issues.” Journal of Advanced Nursing 33(3): 334–42.CrossRefGoogle Scholar
Canadian Association of Midwives. 2008. http://www.canadianmidwives.org/home.htm (Jan. 21, 2008).Google Scholar
CBC. 2007. “Genetics and Reproduction in Depth: Regulating ‘assisted human reproduction.’” http://www.cbc.ca/news/background/genetics_reproduction/rgtech.html (Jan. 29, 2008).Google Scholar
Chodorow, Nancy. 1978. The Reproduction of Mothering. Berkeley: University of California Press.CrossRefGoogle Scholar
Chodorow, Nancy. 1989. Feminism and Psychoanalytic Theory. New Haven: Yale University Press.Google Scholar
CIHI. 2004a. Giving Birth in Canada: A Regional Profile. Ottawa: Canadian Institute for Health Information.Google Scholar
CIHI. 2004b. Giving Birth in Canada: Providers of Maternity and Infant Care. Ottawa: Canadian Institute for Health Information.Google Scholar
CIHI. 2004c. Improving the Health of Canadians. Ottawa: Canadian Institute for Health Information.Google Scholar
CIHI. 2007. Giving Birth in Canada: Regional Trends From 2001–2002 to 2005–2006. Ottawa: Canadian Institute for Health Information.Google Scholar
College of Midwives of British Columbia. 2008. http://www.cmbc.bc.ca/ (Jan. 28, 2008).Google Scholar
College of Midwives of Manitoba. 2007. http://www.midwives.mb.ca/ (Dec. 18, 2007).Google Scholar
College of Midwives of Ontario. 2008. http://www.cmo.on.ca/midwifery.asp (Jan. 28, 2008).Google Scholar
Conrad, Peter. 2007. The Medicalization of Society. Baltimore: The Johns Hopkins University PressGoogle Scholar
De Koninck, Maria. 1998. “Reflections on the Transfer of ‘Progress’: The Case of Reproduction.” In The Politics of Women's Health: Exploring Agency and Autonomy, ed. Sherwin, Susan. Philadelphia: Temple University Press.Google Scholar
Firestone, Shulamith. 1970. The Dialectic of Sex. New York: Bantam Books.Google Scholar
Fountain, L. and Krulewitch, C.J.. 2002. “Trends in Assisted Reproductive Technology.” Journal of Midwifery and Women's Health 47(5): 384–85.CrossRefGoogle ScholarPubMed
Fox, A.A. 1993. “Split subjectivity in country music and honky-tonk discourse.” In All that glitters: country music in America, ed. Lewis, G.H.. Bowling Green, OH: Bowling Green State University Popular Press.Google Scholar
Fukuyama, Francis. 2002. Our Posthuman Future: Consequences of the Biotechnology Revolution. New York: Farrar, Straus and Giroux.Google Scholar
Garry, Ann. 2001. “Medicine and Medicalization: A Response to Purdy.” Bioethics 15(3): 262–69.CrossRefGoogle ScholarPubMed
Gilligan, Carol. 1993. In a Different Voice: Psychological Theory and Women's Development. Cambridge, MA: Harvard University Press.CrossRefGoogle Scholar
Goslinga-Roy, Gillian M. 2000. “Body Boundaries, Fiction of the Female Self.” Feminist Studies 26(1): 113–40.CrossRefGoogle Scholar
Gunn, Jane, Hegarty, Kelsey, Nagle, Cate, Forster, Della, Brown, Stephanie and Lumley, Judith. 2006. “Putting Woman-Centered Care into Practice: A New (ANEW) Approach to Psychosocial Risk Assessment during Pregnancy.” Birth 33(1): 4655.CrossRefGoogle Scholar
Haraway, Donna J. 1991. Simians, Cyborgs, and Women: The Reinvention of Nature. New York: Routledge.Google Scholar
hooks, bell. 2000. Feminist Theory: From Margin to Center. Cambridge, MA: South End Press.Google Scholar
Hoyert, Donna L., Danel, Isabella and Tulley, Patricia. 2000. “Maternal Mortality, United States and Canada, 1982–1997.” Birth 27(1): 411.CrossRefGoogle ScholarPubMed
Inuit Tapiriit Kantami (ITK). 2004. Evaluation models of health care delivery in Inuit regions. Ottawa: ITK.Google Scholar
Inuit Tapiriit Kantami and Nunavut Research Institute. 2006. Negotiating Research Relationships with Inuit Communities: A Guide for Researchers. Igloolik, NU: Nunavut Research Institute.Google Scholar
Jasen, Patricia. 1997. “Race, Culture, and the Colonization of Childbirth in Northern Canada.” Social History of Medicine 10(3): 383400.CrossRefGoogle ScholarPubMed
Kelland, Kate. 2007. Freebirthers Dismiss Fear and Bring Babies Home. Reuters. http://www.reuters.com/article/healthNews/idUSL2148514320070522 (June 22, 2007).Google Scholar
Klein, Michael C. 2004. “Quick Fix Culture: The Cesarean-Section-on-Demand Debate.” Birth 31(1): 161–64.CrossRefGoogle ScholarPubMed
Lock, Margaret. 1998. “Situating Women in the Politics of Health.” In The Politics of Women's Health: Exploring Agency and Autonomy, ed. Sherwin, Susan. Philadelphia: Temple University Press.Google Scholar
Lupton, Deborah. 2000. “‘A Love/Hate Relationship’: The Ideals and Experiences of First-time Mothers.” Journal of Sociology 36(1): 5063.CrossRefGoogle Scholar
MacDonald, Margaret. 2004. “Tradition as a Political System in the New Midwifery in Canada.” In Reconceiving Midwifery, ed. Bourgeault, Ivy Lynn, Benoit, Cecilia and Davis-Floyd, Robbie. Montreal and Kingston: McGill-Queen's University Press.Google Scholar
Mahoney, Maureen A. and Yngvesson, Barbara. 1992. “The Construction of Subjectivity and the Paradox of Resistance: Reintegrating Feminist Anthropology and Psychology.” Signs 18(1): 4473.CrossRefGoogle Scholar
Martínez, Rebecca G. 2004. “'What's wrong with me?': Cervical Cancer in Venezuela: Living in the Borderlands of Health, Disease, and Illness.” Social Science and Medicine 61: 797808.CrossRefGoogle ScholarPubMed
Midwives Alliance of North America. 2007. http://www.mana.org/about.html (June 22, 2007).Google Scholar
Midwives Association of British Columbia. 2007. http://www.bcmidwives.com/midwiferymodel.htm (Dec. 18, 2008).Google Scholar
Mignolo, Walter D. and Tlostanova, Madina V.. 2006. “Theorizing from the Borders: Shifting to Geo- and Body-Politics of Knowledge.” European Journal of Social Theory 9(2): 205–21.CrossRefGoogle Scholar
Miller, Toby. 1993. The Well-Tempered Self: Citizenship, Culture, and the Postmodern Subject. Baltimore: Johns Hopkins University Press.CrossRefGoogle Scholar
Mitchell, Lisa and Georges, Eugenia. 1997. “Cross-Cultural Cyborgs: Greek and Canadian Women's Discourses on Fetal Ultrasounds.” Feminist Studies 23(2): 373.CrossRefGoogle Scholar
Morgan, Kathryn Pauly. 1998. “Contested Bodies, Contested Knowledges: Women, Health, and the Politics of Medicalization.” In The Politics of Women's Health: Exploring Agency and Autonomy, ed. Sherwin, Susan. Philadelphia: Temple University Press.Google Scholar
Nestel, Sheryl. 2006. Obstructed Labour: Race and Gender in the Re-Emergence of Midwifery. Vancouver: UBC Press.Google Scholar
Newnham, Liz. 2006. “The Midwife's Role: Challenges and Changes in the Post-medical Movement towards Woman-centred Care.” Australian Journal of Midwifery 14(4): 1215.CrossRefGoogle Scholar
PAHO. 2005. Gender, Health, and Development in the Americas: Basic Indicators 2005. Washington, DC: Pan American Health Organization.Google Scholar
Parry, Diana C. 2006. “Women's Lived Experience with Pregnancy and Midwifery in a Medicalized and Fetocentric Context.” Qualitative Inquiry 12: 459.CrossRefGoogle Scholar
Pizzato, Mark. 2003. “Soyinka's Bacchae, African Gods, and Postmodern Mirrors.” Journal of Religion and Theatre 2(1): 35104.Google Scholar
Public Health Agency of Canada. 2005. Make Every Mother and Child Count: Report on Maternal and Child Health in Canada. http://www.phac-aspc.gc.ca/rhs-ssg/pdf/whd_05epi_e.pdf (May 9, 2006).Google Scholar
Purdy, Laura. 2001. “Medicalization, Medical Necessity and Feminist Medicine.” Bioethics 15(3): 249–61.CrossRefGoogle ScholarPubMed
Rich, Adrienne. 1986. Of Woman Born. New York: W.W. Norton.Google Scholar
Root, Robin and Browner, C.H.. 2001. “Practices of the Pregnant Self: Compliance with and Resistance to Prenatal Norms.” Culture, Medicine and Psychiatry 25: 195223.CrossRefGoogle ScholarPubMed
Ruddick, Sara. 1995. Maternal Thinking: Toward a Politics of Peace. Boston: Beacon Press.Google Scholar
Scala, Francesca, Montpetit, Eric and Fortier, Isabelle. 2005. “The NAC's Organizational Practices and the Politics of Assisted Reproductive Technologies in Canada.” Canadian Journal of Political Science 38(3): 581604.CrossRefGoogle Scholar
Shanley, Laura. 2008. Bornfree!http://www.unassistedchildbirth.com/ (Jan. 28, 2008).Google Scholar
Sherwin, Susan. 1998. “Introduction.” In The Politics of Women's Health: Exploring Agency and Autonomy, ed. Sherwin, Susan. Philadelphia: Temple University Press.Google Scholar
Society of Obstetricians and Gynaecologists of Canada. 2006. Shortage of Ob/Gyns, Aboriginal Health Top SOGC President's Agenda. News Release: SOGC Annual Clinical MeetingVancouverJune 22–27.Google Scholar
Somerson, Wendy. 2004. “White Men on the Edge: Rewriting the Borderlands in Lone Star.” Men and Masculinities 6(3): 215–39.CrossRefGoogle Scholar
Somerville, Margaret. 2000. The Ethical Canary: Science, and Society and the Human Spirit. Toronto: Viking Press.Google Scholar
Statistics Canada. 2006. The Daily: Monday, July, 31. http://www.statcan.ca/Daily/English/060731/d060731b.htm (Jan. 29, 2008).Google Scholar
Stewart, Donna E. 2006. “Analysis: A Broader Context for Maternal Mortality.” Canadian Medical Association Journal 174(3): 302–03.CrossRefGoogle Scholar
Strozier, Robert M. 2002. Foucault, Subjectivity, and Identity: Historical Constructions of Subject and Self. Detroit: Wayne State University Press.Google Scholar
Taylor, Janelle S. 2000. “Of Sonograms and Baby Prams: Prenatal Diagnosis, Pregnancy and Consumption.” Feminist Studies 26(2): 391.CrossRefGoogle Scholar
UN Millennium Project. 2005. Task Force on Child Health and Maternal Health. Who's Got the Power? Transforming Health Systems for Women and Children. London: Earthscan.Google Scholar
Wacquant, Loïc. 2004. “Following Pierre Bourdieu into the Field.” Ethnography 5(4): 387414.CrossRefGoogle Scholar
Weir, Lorna. 2006. Pregnancy, Risk and Biopolitics: On the threshold of the living subject. London and New York: Routledge.CrossRefGoogle Scholar
Wenman, Wanda M., Joffres, Michel R., Tataryn, Ivanna V. and Group, the Edmonton Perinatal Infectious. 2004. “A Prospective Cohort Study of Pregnancy Risk Factors and Birth Outcomes in Aboriginal Women.” Canadian Medical Association Journal 171(6): 585–89.CrossRefGoogle ScholarPubMed
Whitbeck, Caroline. 1972. “The Maternal Instinct.” In Mothering Essays in Feminist Theory, ed. Treblicot, Joyce. Totowa, NJ: Rowman and Allanheld.Google Scholar
White, Kevin. 1991. “Feminist Approaches to the Sociology of Health.” Current Sociology 39(2): 5057.Google Scholar
Wolf, Naomi. 2003. Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood. New York: Anchor Books.Google Scholar
World Health Organization. Department of Reproductive Health and Research. 2004. Maternal Mortality in 2000: Estimates Developed by WHO, UNICEF, UNFPA. Geneva: World Health Organization.Google Scholar
Yamin, Alicia Ely and Maine, Deborah P.. 2005. “Maternal Mortality as a Human Rights Issue: Measuring Compliance with International Treaty Obligations.” In Perspectives on Health and Human Rights, ed. Gruskin, Sofia. New York: Routledge.Google Scholar
Young, Iris Marion. 1984. “Pregnant Embodiment: Subjectivity and Alienation.” The Journal of Medicine and Philosophy 9: 4562.CrossRefGoogle ScholarPubMed
Zola, Irving Kenneth. 1972. “Medicine as an Institution of Social Control.” Sociological Review 20: 487504.CrossRefGoogle ScholarPubMed