Maktfyllda möten i medicinska rum: debatt, kunskap och praktik i svensk förlossningsvård 1960-1985
Author
Summary, in English
The main purpose of this thesis is to analyze debates around and changes in knowledge production and medical practices of childbirth between 1960 and 1985 in Sweden. The roles of the different actors involved, such as physicians, midwives, the National Board of Health and Welfare, the women’s movement and politicians are studied in four main contexts: medical practice and debate, the Swedish Parliament, women’s movement and the more general debate, as reflected in the media. Donna Haraway’s theoretization of situated knowledges and material-semiotic practices provides the study’s theoretical point of departure.
The study identifies three important shifts. The first took place in the 1960s and early 1970s, and was characterized by considerable technological optimism which transformed obstetrics to a practice of active management of labour. There was a medical vision of being able to gain full knowledge of the foetus by means of electronic monitoring. I conclude that a result of this was that the foetus was figured as a patient exposed to risk, the physician as the protector of the foetus and the woman reduced to a body in need of surveillance but also a mother that could get in contact with the foetus through the technology/physician. In the second shift in the early 1970s the questions of childbirth became politicized through debates in the women’s movement, the media and the Parliament, mainly concerning women’s right to pain relief. I show that central to the debate was contestations over women’s experiences and knowledge as opposed to medical knowledge and practice. The debate thus actualized questions of boundaries between medicine and politics. The third shift took place in the mid-1970s to mid-1980s, through a psychologization of birth based on new knowledge paradigms within medicine. A central aspect that I identify is that the woman was figured as fragile or psychologically unstable and in need of expert help to bond with her child and become a good mother. I argue that even though psychological problems were lifted out of the social context, the medical focus was on the modern woman’s lack of naturalness, a lack resulting in difficulties in giving birth and adapting to the mother’s role. Both midwives and physicians figured themselves as spokespeople for women giving birth by claiming that they supported a less technical, more holistic, woman-centered system at the same time as the women’s movement emphasized psychological aspects and argued that women should give birth naturally, on their own terms, not those of the hospital, technology or doctors.
One of the main contributions of this study is to problematise the dichotomy between (bad) technology and (good) nature that has characterized earlier research using a medicalisation perspective. I have instead explored how nature and technology were mobilized, how the dichotomy between them were created and used, by whom, what it achieved and why it became so important. Drawing on Haraway’s concept implosions I have shown that natural was a useful concept for those who wanted to figure themselves as spokespeople for women and at the same time presenting motherhood as nature’s plan for women at a time when such assumptions were being questioned though women’s movement and debates around gender equality. I also argue that through an emphasis on the border between nature and technology medical actors could protect their dominance over medicine and direct attention away from the attempts to contest existing boundaries between medicine and politics.
The study identifies three important shifts. The first took place in the 1960s and early 1970s, and was characterized by considerable technological optimism which transformed obstetrics to a practice of active management of labour. There was a medical vision of being able to gain full knowledge of the foetus by means of electronic monitoring. I conclude that a result of this was that the foetus was figured as a patient exposed to risk, the physician as the protector of the foetus and the woman reduced to a body in need of surveillance but also a mother that could get in contact with the foetus through the technology/physician. In the second shift in the early 1970s the questions of childbirth became politicized through debates in the women’s movement, the media and the Parliament, mainly concerning women’s right to pain relief. I show that central to the debate was contestations over women’s experiences and knowledge as opposed to medical knowledge and practice. The debate thus actualized questions of boundaries between medicine and politics. The third shift took place in the mid-1970s to mid-1980s, through a psychologization of birth based on new knowledge paradigms within medicine. A central aspect that I identify is that the woman was figured as fragile or psychologically unstable and in need of expert help to bond with her child and become a good mother. I argue that even though psychological problems were lifted out of the social context, the medical focus was on the modern woman’s lack of naturalness, a lack resulting in difficulties in giving birth and adapting to the mother’s role. Both midwives and physicians figured themselves as spokespeople for women giving birth by claiming that they supported a less technical, more holistic, woman-centered system at the same time as the women’s movement emphasized psychological aspects and argued that women should give birth naturally, on their own terms, not those of the hospital, technology or doctors.
One of the main contributions of this study is to problematise the dichotomy between (bad) technology and (good) nature that has characterized earlier research using a medicalisation perspective. I have instead explored how nature and technology were mobilized, how the dichotomy between them were created and used, by whom, what it achieved and why it became so important. Drawing on Haraway’s concept implosions I have shown that natural was a useful concept for those who wanted to figure themselves as spokespeople for women and at the same time presenting motherhood as nature’s plan for women at a time when such assumptions were being questioned though women’s movement and debates around gender equality. I also argue that through an emphasis on the border between nature and technology medical actors could protect their dominance over medicine and direct attention away from the attempts to contest existing boundaries between medicine and politics.
Department/s
Publishing year
2008
Language
Swedish
Document type
Dissertation
Publisher
Sekel Bokförlag
Topic
- History
Keywords
- gender
- childbirth
- maternity care
- medicine
- foetus
- midwives
- women's movement
- medical technology
- CTG
- pain relief
- nature/natural
- body
- situated knowledges
- history
- Donna Haraway
- 1960-1985
- Sweden
Status
Published
Supervisor
- Lena Lennerhed
- Kerstin Sandell
ISBN/ISSN/Other
- ISBN: 978-91-85767-25-0
Defence date
26 September 2008
Defence time
13:00
Defence place
Södertörns högskola, sal MB 503, Alfred Nobels Allé 7, Flemingsberg
Opponent
- Karin Johannisson (Professor)