{"title":"Discourses of Childlessness in Bangladesh","authors":"Mirza Taslima Sultana","doi":"10.1093/oso/9780190130718.003.0012","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0012","url":null,"abstract":"This chapter explores the discourses around medical and alternative treatments that emerged in the accounts of 11 middle-class Bengali women who sought treatment for their childlessness. Fertility has been considered a prime problem for Bangladesh since the 1980s, and policy documents still focus on fertility reduction, along with reducing maternal mortality. Yet, no recent policy documents considered childlessness as a problem. This investigation informs of the links between biomedical power and childlessness as they are emerging in urban Bangladesh. The sections of this chapter discuss the concepts of biopower and agency, illustrate the different trajectories interviewees pursued in dealing with childlessness, focus on the issue of the so-called perfect age for assisted reproductive technology (ART) treatments, and explore interviewees’ stories of their experiences of IVF. The concluding section discusses these women’s accounts of the beliefs according to which they actively decide their technological options.","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127153466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Son Preference in India","authors":"Clémence Jullien","doi":"10.1093/oso/9780190130718.003.0010","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0010","url":null,"abstract":"Through a focus on Rajasthan, this chapter analyses how government awareness campaigns for gender equality, as well as a sharp rise in institutional deliveries throughout the country in the 2000s, have affected how son preference is discussed and treated in hospitals. Drawing on 3 months of ethnographic fieldwork in a government hospital in Jaipur, this chapter shows that the condemnation of son preference has enhanced regimes of medical and moral surveillance within obstetric wards. Not only does it contribute to further castigation and self-disciplining mechanisms, but it also constitutes a new opportunity for social distinction. While condemning son preference practices, women, nurses, and doctors are constantly finding scapegoats in social classes, state, and generational differences. Thus, this chapter considers whether the public condemnation of son preference, currently jeopardizing the relationship of trust between caregivers and patients, could undermine government policies on safe motherhood.","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130018621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"‘Since It’s a Pleasure to Save Somebody’s Life, I Do This’","authors":"H. Vallianatos","doi":"10.1093/oso/9780190130718.003.0005","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0005","url":null,"abstract":"Health development efforts to decrease maternal and neonatal morbidity and mortality in South Asia have included a role for trained and/or traditional birth attendants since the late 20th century. Birth attendants are typically older women, who assist not only during birth but who also can provide counsel during pregnancy and lactation. Based on an ethnographic case study, focused on a jhuggi-jhopri (squatter) settlement in New Delhi, this chapter differentiates between two types of birth attendants. Traditional birth attendants are women who have learned their skills and knowledge, typically from elder women relatives, through apprenticeship. Their tools of practice include herbal knowledge as well as ‘modern’ medical kits they may have received through health education efforts (for example, scissors to cut the umbilical cord). In contrast, trained birth attendants are older women who were recruited through local health organizations (both governmental and non-governmental) and trained by biomedical practitioners to provide frontline care. This chapter examines both traditional and trained birth attendants’ perspectives on assisting local mothers, examining how local mothers view traditional versus trained birth attendants and, in turn, how this may affect their birth experiences","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115629303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Outsiders in the Village","authors":"J. Killmer","doi":"10.1093/oso/9780190130718.003.0007","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0007","url":null,"abstract":"A shortage of women doctors in Rajasthan’s rural government sector has left sizeable gaps in the provision of women’s healthcare. This chapter explores how, in their narratives, women doctors position themselves as outsiders in the village, unable to create successful careers and lives in rural spaces. Medical graduates considering a rural career must contend with the hierarchy of medical prestige that places cities above villages and the timescale that frames villages as ‘backwards’ spaces. In doctors’ narratives of the village, doctors used the village as code for low educational and class status—and by separating themselves from the geographical space of the village, they also put metaphorical distance between themselves and their subaltern Other. Women doctors’ reluctance to occupy rural space illuminates the ways that class, space, and gender overlap to shape the practice of healthcare, with impacts felt far beyond the careers of doctors.","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129892871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Training Birth Attendants in India","authors":"P. H. Petitet","doi":"10.1093/oso/9780190130718.003.0004","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0004","url":null,"abstract":"This chapter documents the local and global processes of construction, legitimization and delegitimization, and the political uses of the knowledge of traditional birth attendants—TBAs. Based on four years’ ethnographical investigation in Tamil Nadu, this chapter discusses the issue from various points of view. It looks at the debates of actors involved in the national and international public health agendas, Indian movements promoting ‘Natural Childbirth’, and movements in favour of the preservation of traditional systems of medicine. TBAs are variously perceived as wicked mothers whose archaic practices must be controlled, the archetypal ambassadors of traditional knowledge, or as relevant actors bringing together ideal elements of any development activity—locality, community, and low cost. This careful reading of the contemporary social representations of TBAs and of their role reconfigurations offers a lens to examine authoritative knowledge’s social forms, practices, and paradoxes.","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127503325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Politics of Childbirth in Nepal","authors":"J. Sharma, R. Adhikari","doi":"10.1093/oso/9780190130718.003.0011","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0011","url":null,"abstract":"Nepal has been hailed as a global success in reducing the maternal mortality ratio from around 540 women dying per 100,000 births in 1996 to about 240 in 2016. The chapter will critically analyse two interventions implemented around 2005. First, we will look at the USAID-funded Nepal Family Health Program, through which oral misoprostol (to control bleeding after delivery) was launched across Nepal. Second, we will look at Aama Surakshya Karyakram (or mother programme), which was implemented to promote institutional delivery. These two programmes, despite aiming to address high maternal mortality ratio in Nepal, adopted very different approaches, reflecting ideological struggles on women’s agency and the politics of childbirth. The chapter concludes that the costs of these changes (such as the lack of resources or the commercialization of healthcare) have been overlooked in the claims of Nepal’s ‘success’.","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"23 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130221605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isabelle L Lange, Sunita Bhadauria, Sunita Singh, Loveday Penn-Kekana
{"title":"Care’s Profit","authors":"Isabelle L Lange, Sunita Bhadauria, Sunita Singh, Loveday Penn-Kekana","doi":"10.1093/oso/9780190130718.003.0008","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0008","url":null,"abstract":"Using a layered, ethnographic approach focusing on four small non-corporate private maternity hospitals, we turn a critical lens on what it means to work within this self-regulated bubble and examine the ‘creation’ of a cadre of healthcare workers. Our analysis addresses how a space of care and business is generated out of the precarious positions of both women and the health workers who depend on employment there. Clinic owners’ staffing strategies centred on hiring unlicensed labour room staff, trained on the job rather than in accredited institutes, who take care of all aspects of patient care, including deliveries. By exploring narratives surrounding training and overtreatment, this chapter highlights the tensions between the value placed on profit, care, and working conditions in the private maternal health sector, and examines the structural vulnerability of unlicensed health providers working there.","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128521047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Changing Childbirth in Twenty-First-Century South Asia","authors":"Clémence Jullien, R. Jeffery","doi":"10.1093/oso/9780190130718.003.0001","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0001","url":null,"abstract":"This introduction sets out why childbirth is a salient and timely issue for South Asia—for example, continuing, relatively high maternal and child mortality rates; growing health inequities within the countries; and new and unprecedented government schemes. It discusses the old challenges and new paradoxes of childbirth in South Asia in a global context, by reviewing the main turning points of state policies of four South Asian countries (India, Pakistan, Nepal, and Bangladesh) over the last century.\u0000After offering an overview of some main policy reforms, the introduction explores the ambivalent effects of the introduction of new obstetrical technologies (including institutional practices) and the medicalization of childbirth. A third section reflects on the scope and the importance of rights-based approaches in maternal healthcare. The chapter concludes by explaining the structure of the book and briefly introducing each chapter.","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"240 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123882058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Digitalizing Community Health","authors":"Marine Al Dahdah, Alok Kumar","doi":"10.1093/oso/9780190130718.003.0013","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0013","url":null,"abstract":"Through the study of ‘Motech’—a global mHealth programme on maternal health implemented in Ghana and India—this chapter offers the first analysis of the use of mobile phones as a tool in such programmes. This chapter focuses on the particular role of community health workers in establishing this programme. It questions the competing strategies to enhance or substitute these workers that are linked to the expansion of these new technical artefacts. This vision—of the health worker assisted by the mobile—is twofold: on the one hand, it would make the health worker efficient and omniscient; on the other hand, it calls into question the knowledge of health workers and their autonomy through an automated system of communication. This research provides a better understanding of the special status of mobile phones and mHealth applications for community health workers and how their use changes the practice of community health.","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116337021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Forms and Ethics of Baloch Midwifery","authors":"Fouzieyha Towghi","doi":"10.1093/oso/9780190130718.003.0003","DOIUrl":"https://doi.org/10.1093/oso/9780190130718.003.0003","url":null,"abstract":"In Pakistan, the rise of unnecessary uterotonic injections to induce childbirth, sometimes also resulting in hysterectomies, has women returning to dhīnabogs (Baloch midwives) to heal the iatrogenic effects of biomedical interventions; and reinforcing local assumptions about the benefits of Balochi dhawā/medicine, dhīnabogiri or midwifery, and homebirths. Drawing on ethnographic research in Balochistan the chapter traces how dhīnabogs’ work, ethical stances, and critical outlook concerning the iatrogenic effects of biomedical interventions are non-oppositional forms of everyday resistance. The protective role of dhīnabogiri is embedded in the intimate aspects of childbirth that profoundly structure the ethical relationship between the labouring woman and her dhīnabog. This relationship is defined not only by dhīnabogs’ concern for the well-being of mother and child, but also by their character and ethics, which are inscribed in the vernacular and social authorized praxis of dhīnabogs , kawwās (expert midwives) and balluk (granny midwives).","PeriodicalId":344693,"journal":{"name":"Childbirth in South Asia","volume":"404 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129239080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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