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Risk, Reproduction, and Narratives of Experience

Lauren Fordyce

Publication Year: 2012

As Carole Browner explains in her foreword: "These chapters compellingly reveal that although we anthropologists tend to speak of biomedicine in hegemonic terms, in fact its penetration is quite variable and often ambivalently met. . . . Risk, Reproduction, and Narratives of Experience sheds new light on a troubling core aspect of medicalization processes, which simultaneously render pregnant women more docile subjects even as they are impelled to actively engage with biomedicalized prenatal care regimes. . . . We also see that a consummate means by which states seek to consolidate power in the reproductive realm is through expansion of the biomedical concept of risk. This critical observation emerges repeatedly in this collection."

Published by: Vanderbilt University Press

Title Page, Copyright, Dedication

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Table of Contents

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Foreword

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pp. ix-xi

Women have been bearing and caring for children since the dawn of time. And as best we know, pregnancy and the act of giving birth have always been recognized as times of vulnerability, uncertainty, and danger—as much for pregnant women and new mothers as for the larger groups to which they belong. It is for this reason that...

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Acknowledgments

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pp. xiii-

Lauren Fordyce and Amínata Maraesa would like to thank all the contributors to this volume for their hard work and patience in seeing this text from the planning stages through to its completion. We are very grateful to Carole Browner, who generously agreed to write the Foreword to this text, sent us helpful feedback...

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Introduction: The Development of Discourses Surrounding Reproductive Risks

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pp. 1-13

With the rise of reproductive technologies, contested struggles over reproductive choice, and the global proliferation and normalization of reproductive freedoms has come an increase in the attention and scrutiny surrounding individual behaviors and group actions associated with poor reproductive outcomes. What was once the domain of chance, fate, or divine will has been repositioned as behavioral “risk,”...

I. Complications in Measuring and Defining Risk

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1. Conceiving Risk in K'iche' Maya Reproduction

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pp. 17-36

In the department of Quetzaltenango in Guatemala’s western highlands, different meanings of risk attach to pregnancy and its management for three distinct groups of health care providers: local physicians, regional workers for an international NGO working to improve health quality in maternal and infant health services, and K’iche’ Maya traditional birth attendants (TBAs)—midwives, or, in Spanish,...

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2. Failing to See the Danger: Conceptions of Pregnancy and Care Practices among Mexican Immigrant Women in New York City

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pp. 37-57

Rosa migrated from Puebla’s state capital three years before becoming pregnant and seeking prenatal care at Manhattan Hospital.1 I asked her if she planned to have anesthesia during labor and delivery. While her husband massaged her back, she told me she did not....

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3. The Vital Conjuncture of Methamphetamine-Involved Pregnancy: Objective Risks and Subjective Realities

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pp. 59-77

Claudia, a twenty-eight-year-old, went into the hospital during labor and called her “connect” (drug dealer) to bring her some methamphetamine (meth) because the doctors were “not doing anything” to stop her contractions.1 She snorted some meth and then prayed not to “test dirty,” that is, positive for drug use. Claudia recalls: “I felt so ashamed. I wanted to kill myself, but I just prayed to God and...

II. Biopolitical Narratives of Risk and Responsibility

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4. Birth and Blame: Guatemalan Midwives and Reproductive Risk

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pp. 81-101

The beautiful and scenic vistas of Guatemala, the Land of Eternal Spring, mask the realities of a country with one of the highest infant mortality rates and maternal mortality ratios in Central America and the Western hemisphere. With a current infant mortality rate of 26.9/1,000 live births (CIA 2010) and maternal mortality at 153/100,000 live births (Franco de Mendez 2003; PAHO 2007; Repogle 2007),...

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5. "They Don't Know Anything": How Medical Authority Constructs Perceptions of Reproductive Risk among Low-Income Mothers in Mexico

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pp. 103-121

The Mexican state has promoted the concept of the modern woman with great enthusiasm, with low-income women the primary target. Many of these women are accused of engaging in risky and less than modern behavior, such as receiving prenatal care with midwives instead of physicians or not practicing family planning (see Gálvez, this volume, for contrasting prenatal practices among Mexican...

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6. Local Contours of Reproductive Risk and Responsibility in Rural Oaxaca

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pp. 123-140

The two messages about good reproductive health that introduce this chapter, the first from a mural outside a small community health clinic in rural Oaxaca, Mexico, and the second by the clinic’s director, remind women that they are responsible for their children’s healthy futures. Further, they suggest that this responsibility involves specific forms of care practices learned at the clinic and, implicitly, that...

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7. New Countryside, New Family: The Discourses of Reproductive Risk in Postsocialist Rural China

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pp. 141-154

After three decades of economic reform and a massive effort toward “modernization construction” (xiandaihua jianshe), China has become an emerging world power. Challenging the image of modernity, however, is the huge gap in reproductive health that exists between China’s underdeveloped west and well-developed east. In the impoverished rural southwest region of China, exceedingly high rates of...

III. Struggles over the Embodiment of Reproductive Risk

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8. Negotiating Risk and the Politics of Responsibility: Mothers and Young Child Health among Datoga Pastoralists in Northern Tanzania

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pp. 157-172

The strategies that mothers use to prevent and negotiate infant illness are a useful interface for understanding the complex relationship between risk and reproduction on both an individual and a societal level. This chapter gives a brief background to the construction of risk and harm reduction among Datoga women and uses research on diarrheal illness in north-central Tanzania as a case study to...

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9. Shifting Maternal Responsibilities and the Trajectory of Blame in Northern Ghana

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pp. 173-189

One afternoon early in my fieldwork in the Upper East Region of Ghana, I accompanied a local NGO worker and a community health nurse to visit a sick three-year-old girl named Azuma, her mother, Abiiro, and their extended family.1 The NGO worker had concerns not only about Azuma’s poor health, but also about circulating rumors that the family suspected her of being a “spirit child”—...

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10. Imaging Maternal Responsibility: Prenatal Diagnosis and Ultrasound among Haitians in South Florida

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pp. 191-209

One afternoon toward the end of my ethnographic fieldwork in South Florida, I received a call from the nurse-practitioner at Prenatal Clinic, the public clinic where I was conducting participant-observation. Portia told me that she had given my name and number to a local obstetrician.1 She explained: “Dr. Albert is the perinatologist who runs the ultrasound clinic where I send the patients who don’t...

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11. A Competition over Reproductive Authority: Prenatal Risk Assessment in Southern Belize

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pp. 211-229

By six o’clock on Wednesday mornings the market in the town of Punta Gorda is already buzzing with distant villagers and local townspeople. While there are a few Garinagu merchants selling cassava sweets and Mestizo-owned dry-goods storefronts, most of the vendors are rural-dwelling Kekchi- and Mopan-speaking Maya—primarily women—who come into town to sell a variety of harvested items...

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Afterword

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pp. 231-233

The chapters of Risk, Reproduction, and Narratives of Experience that you have just read all operate in an existential gap: in this gap, each woman’s pregnancy is in deep, abstract conversation with every woman’s pregnancy as experts aggregate and analyze them, whether in urban Los Angeles and Puebla, Mexico, or rural Belize, Ghana, and China. In this existential gap, the twinned concepts of risk and responsibility...

Contributors

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pp. 235-236

Index

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pp. 237-241


E-ISBN-13: 9780826518217

Publication Year: 2012

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Subject Headings

  • Childbirth -- Cross-cultural studies.
  • Maternal health services -- Cross-cultural studies.
  • Health risk assessment -- Cross-cultural studies.
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