GRADUATION!

School's out for Summer! School's out FOREVER! 

The time has come. After 3 grueling years of non-stop classes, extracurriculars, work, writing, presenting, traveling, home work, and more, I am FINALLY GRADUATING!

It feels a little bit anti-climactic, to tell the truth. I was much more relieved when my thesis was approved and turned in. That felt like a momentous occasion! But all my accomplishments were hard-won, and I am really excited to put my new degrees behind my name.

I really do feel like an "expert" now, which I would not have felt comfortable calling myself before grad school! So thank you, grad school, for beating the knowledge and skills into me.

Anyone who thinks that grad school will be just like undergrad, I have to agree with what everyone told me - It is not. There is a LOT more time and effort involved. It is less about the experience and more about building your career. You have to be self-motivated. It is about a lot more than just the coursework. Every single moment must be spent gaining experience, growing your skills, and making connections. You apply to every job, every conference, every volunteer opportunity. Attend every community event, fundraiser, workshop and seminar as you possibly can. Apply for every scholarship, every leadership position, and every training.

My experiences in my public health department were very different than my experiences in my anthropology department. I am more than glad that I have both perspectives. Public health was great for growing my actual hands-on skills, helping me make connections, funding me, and giving me an opportunity to see the direction my work will probably take in the future. However, my public health classmates and courses were somewhat (on the whole, not as a rule), less motivated and rigorous than my anthropology classmates and coursework. Anthropology provided my with rich discussions, challenging reading assignments, theoretical foundations, and understanding the larger systems connections that sometimes public health lacks. There are no big long discussions about race, gender, class and so forth in public health. The way PH discuss health systems is dry. Anthropology, on the other hand, makes it relevant and fascinating. So, I can see where my anthropology colleagues are lacking an understanding of working in public health, and where my public health colleagues are lacking a vital anthropological perspective.

But enough on that now...

I HAVE TO GO GRADUATE!

A Short Grad School Rant

Thesis woes...
I am thisclose to having my thesis entirely done and turned in.

Funny, in undergrad I knew that my whole committee didn't read my entire thesis, but it didn't really matter. My advisor didn't care if everyone had read it, if I had incorporated their opinions. I just defended it and turned it in and moved on. This time around, however, even though I don't have a defense, it feels more serious. My advisor provided me with very specific revisions, most of which I am grateful for (only some of which made me somewhat frustrated). Playing the waiting game with my committee has been harder than I thought. I had assumed this month would be insane - getting revisions back, turning them back around, getting more... And so far I've only gotten revisions from one professor. I've had to track down another committee member (unsuccessfully) who has had my draft for  6 weeks and definitely hasn't even started reading it. The neat "rounds" of editing/revisions/drafts that I had envisioned fell apart when I had to just submit a second draft to my committee before hearing from others members. Of course, people would probably say that this is to be expected. But I guess we all go into it optimistically - 'maybe MY professor will be awesome and actually work WITH me to make deadlines!' So far, I still need to hear from two people and I have to be entirely done and submitted in two weeks. So, I wait. And try to make myself do other productive things.

I'll admit I have a serious case of senioritis. I've always been one of those hard-working people who definitely does work every weekend and in the evenings and during vacations. I find it incredible when colleagues or friends tell me they blew off the entire weekend, or still aren't done with an assignment at the eleventh hour. But this semester, that has been me. After 3 years of hardcore grad school, I am ready to be DONE. "They" always say that graduate school is nothing like college, and they are right. It is 10x the amount of reading, 10x the amount of work outside of the classroom. You are building your career, so it is up to you to gain experience through grad assistantships, internships, volunteering, speaking at conferences, getting research grants AND doing well in school and networking. Plus, oh yeah! Most grad students have work or families outside of school at this point, and they're juggling their full-time academic life with a full-time home life.

I wanted so desperately to go back to school, and now I am so ready to just have a job and free time.  Though, I admit, if I had the money... I'd definitely continue taking classes just for the LEARNING. I have loved everything that I have learned (I just don't enjoy the stress!) I would much rather plan my wedding and have doula clients as my "homework" than all of this other stuff. Which I'm doing anyway, on top of everything else.

After I graduate I will miss having free access to all of those articles, though... I love being able to just log-in and find research and evidence on my favorite subject matters - birth and breastfeeding! I wonder if I could work out a way to not be cut off by my university. And sadly, I don't have time to take advantage of them before I graduate in May. Perhaps I'll have more time to blog, though, after graduation.

In other news, even though I don't have a lot of time to blog, I still skim blogs and articles and tweet them a lot! So you can find me there or on the Facebook page for the time being :)

My Thesis EDD

My master's thesis EDD is coming up - the general date around which I need to have my full first draft completed and submitted to my advisers and committee members. After it is out of my hands, that uncomfortable period of waiting for their completely red-marked up copies to be returned to me begins. I know it is going to happen any time, just please let the pain begin so I can get it over with! Once my committee hands it back to me, labor starts. I will have to labor for an unknown about of time over their suggested revisions, knowing that I will have to give birth to a fully completed thesis at some point! This can't last forever! The baby/thesis will need to be born soon!

http://www.phdcomics.com/comics/archive.php?comicid=344

http://www.phdcomics.com/comics/archive.php?comicid=718

Sorry I don't have a lot for you on the blog lately, I'm a bit absorbed with condensing my research into one sentence ;)

What's going on in my world

If you're a doula, do you compensate/get compensated for being back-up on call? A while back I agreed to be back up for another doula and she paid me a small amount just for being on call, even though she attended the birth herself. In the past my back up arrangements have just been a pay-if-you-go type thing. I think everyone has a different system for this, and I'm just curious! Please share :)

I recently attended a birth where we labored at home until the mom felt an urge to push. We made our way downstairs, into the car, and all the way to the hospital and mom was doing great. We entered through the emergency room entrance, which is always how I've entered with clients at this particular hospital. When we entered, the woman at the desk asked "how far apart are her contractions? does she feel like she has to push?" So I calmly replied, "her contractions are about 2 minutes apart, and she is feeling a little bit like pushing." For some reason the emergency room (guy? tech? nurse? doc? I don't really know) decided that this meant she was about to have her baby, and wheeled the mom in her wheelchair over to an empty room and put on a face mask and gloves. I thought perhaps they were just going to check her dilation down there and then we'd go up to labor and delivery, but I realized that he had thought the baby was coming NOW. He turns to the mom as she's standing up from her wheelchair and says "do you feel like pushing?!" and she calmly says, "every now and then I feel the urge to push with a contraction, but not every one." And he's like "oh." And everybody stands down, and we are handed over to someone and taken to L&D. haha. I found it highly amusing. Have you ever had this happen before?

I've been analyzing my thesis research data lately and I keep thinking of one mom who described breastfeeding as "animalistic." Interestingly, exactly 1/3 of the women I interviewed had a cesarean section birth (the exact same as the entire United States).

If you're a spanish-speaker, what word is most often used for "breast pump"? sacaleches? bomba? pompa? I say pompa because I've heard it used, but when I actually look it up I get the first two.

A month ago I received a phone call inquiring about my doula services. The woman started the phone call out with "is this... the doula?" Apparently she forgot my name as the phone was ringing. But it didn't seem she paid much attention to my website anyway, since she apparently had no idea what a doula is or does. She proceeded to ask me whether I go with her to all of her doctor's visits with her throughout her pregnancy, and if I do ultrasounds. I sure hope she figures it out sooner rather than later. I haven't heard back from her!

Personal Update

A lot of this blog is about sharing information that I find that's new or interesting, and not as much about personal doula updates anymore. I used to do a lot more back at the beginning of the blog when I was just starting out. I even posted some or my doula birth stories! But when I got some flack about sharing too much personal information, I sort of stopped.

Also, as I'm in grad school, I don't take on a lot of clients. My semesters have really been ramping up the longer I am in this program, and I just haven't felt like I could handle being on-call.  As a result, I don't want to come on here all the time and write about my meetings or births or impressions just in case my professional identity can be linked to this blog, and my clients get upset about something I say on here. Also, because I don't take on a lot of clients, there's less to share in general!

But since I haven't done a personal doula life update (or a "doula journey" post) in a while, I thought I'd take the time to write one down.

I've recently taken on some fabulous clients that are due this summer. One client interviewed and hired me at only 10 weeks gestation! So it has been an interesting experience having a client that long. I worried about the potential for having to go through a miscarriage with her (which thankfully didn't occur), and also about how to keep the relationship over such a long time (I'm used to the meetings all occurring in the last trimester of pregnancy - sometimes even the last month only!). So far it has worked out. I went on a hospital tour with them, so it was great to see them and chat then. She has kept up with e-mailing me with photos of her baby bump, the baby's sex, and lots of questions, so that's been great, too! They also invited me to a baby shower, and we will soon start our prenatal appointments together.

Two additional clients are both due in the same month, so I am glad to have some back up support from my wonderful back-up doula. With the first, the husband seems very concerned that he will have a highly active role to play, that I will just be there to give him reminders of what to do. Until I spelled that out multiple times in several different ways, I didn't see his smile. Dads are always all-business, while moms do most of the talking. My other client is of an older age, and I always find that the older moms who are pregnant for the first time do a LOT of talking. She tells me everything! I think it is really great. She is also delivering at a birth center that I haven't been to, yet, so I'm excited to meet the midwives there and have that experience.

Recently my doula friend who is still certifying asked me if she could shadow me on one of my births. She has already asked the permission of my client and gotten it. I have never had a doula shadow me, and I'm not sure how that will go! I almost don't feel like I'm seasoned enough to provide guidance for a doula-in-training, and I'm wondering how it will change the way I doula. Can anyone give any advice on this?

Once my semester ends I'll be taking a 5-day Certified Lactation Counselor (CLC) training. I'm very excited for this, as I've wanted to add additional breastfeeding training to my skill set, and also because I'm hoping it will provide hours for my birth doula re certification requirements with DONA.  If you're a DONA doula and you'd like more info on re certification requirements, they recently made a webinar on this topic! Additionally, serving as a preceptor at a birth with a doula-in-training counts as an alternative method to obtain continuing education contact hours!

In other news, I am officially Certified in Public Health, now that I've found out that I passed my CPH Exam!

More Reproductive Anthropology Readings

So, the semester got away from my and I never did keep up with typing up my Anthropology of Reproduction readings and notes. But hey, half of the syllabus is pretty good. Here is a list of the rest of the readings, in case you're interested personally, academically, or educationally!

Past reading lists and notes are available here: Anthropology of Reproduction Part 1, Anthropology of Reproduction Part 2, and Childbirth/Breastfeeding Day in Anthropology

Abortion

Chi, B. K., T. Gammeltoft, et al. (2010). "Induced abortion among HIV-positive women in Quang Ninh and Hai Phong, Vietnam." Tropical Medicine & International Health 15(10): 1172-1178.

Grossman, D., K. Holt, et al. (2010). "Self-induction of abortion among women in the United States." Reproductive Health Matters 18(36): 136-146.

Joffe, C. and T. Weitz (2003) Normalizing the exceptional: incorporating the “abortion pill” into mainstream medicine. Social Science and Medicine 56:2353-2366.

Roth, R. (2004) Do Prisoners Have Abortion Rights? Feminist Studies 30,2:353-381.

Schuster, S. (2010). "Women's experiences of the abortion law in Cameroon." Reproductive Health Matters 18 (35): 137-144.

Infertility/Assisted Reproduction

Bharadwaj, A. (2003) Why adoption is not an option in India: the visibility of infertility, the secrecy of donor insemination, and other cultural complexities. Social Science and Medicine 56:1867-1880.

Berend, Z. (2010). "Surrogate Losses." Medical Anthropology Quarterly 24(2): 240-262.

Birenbaum-Carmelia, D and M. Dirnfeldb (2008) In Vitro Fertilisation Policy in Israel and Women’s Perspectives: The More the Better? Reproductive Health Matters 16(31):182–191.

Friese, C. G. Becker, and R.D. Nachtigall (2008) Older motherhood and the changing life course in the era of reproductive technologies. Journal of Aging Studies 22 (2008) 65–73.

Hough, C. A. (2010). "Loss in childbearing among Gambia's kanyalengs: Using a stratified reproduction framework to expand the scope of sexual and reproductive health." Social Science & Medicine 71(10): 1757-1763

Sexually Transmitted Infections

Buelna, C., E. Ulloa, and  M. Ulibarri, (2009) Sexual Relationship Power as a Mediator Between Dating Violence and Sexually Transmitted Infections Among College Women

Journal of Interpersonal Violence. 24,8: 1338-1357

Daley, E. et al. (2010) “Influences on Human Papillomavirus Vaccination Status Among Female College Students” Journal of Women's Health.  19(10): 1885-1891.

Dyer, K. E. (2010) “From Cancer to Sexually Transmitted Infection: Explorations of Social Stigma among Cervical Cancer Survivors” Human Organization 69: 321-330.

Gautham, M., R. Singh, H. Weiss, R. Brugha et al. (2008) Socio-cultural, psychosexual and biomedical factors associated with genital symptoms experienced by men in rural India. Tropical Medicine and International Health, 13(3):384–395.

Philpott, A., W. Knerr, and V. Boydell. (2006) Pleasure and prevention: when good sex is safer sex. Reproductive Health Matters 14(28): 23-31.

Special Populations

Ballard, K.D., M.A. Elston, J. Gabe (2009). Private and Public Ageing in the UK. The Transition through the Menopause. Current Sociology 57(2): 269-290.

Lewin, E. (1995) On the Outside Looking In:  the Politics of Lesbian Motherhood. In Ginsburg and Rapp Conceiving the New World Order: The Global Politics of Reproduction. California University Press: 103-121.

Marhefka, S. L., C. R. Valentin, et al. (2011). "I feel like I'm carrying a weapon.”  Information and motivations related to sexual risk among girls with perinatally acquired HIV." AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV.

Smid, M., P. Bourgois, et al. (2010). "The Challenge of Pregnancy among Homeless Youth: Reclaiming a Lost Opportunity." Journal of Health Care for the Poor and Underserved 21(2 Suppl): 140.

Buhi, E. et al. (2010) Quality and Accuracy of Sexual Health Information Web Sites Visited by Young People. Journal of Adolescent Health 47:206-208.

Circumcision

Belisario, O. C. V. (2010). “Muslim Women and Circumcision: A Study of Intergenerational Practice and its Continuity in Southern Philippines." WMSU Research Journal 28(1).

Johansen, R. (2006) Care for infibulated women giving birth in Norway: an anthropological analysis of health workers’ management of a medically and culturally unfamiliar issue. Medical Anthropology Quarterly 20(4): 516-544.

Kurth, E., F. Jaeger, et al. (2010). "Reproductive health care for asylum-seeking women-a challenge for health professionals." BMC Public Health 10(1): 659.

Obure, A. F. X. O., E. O. Nyambedha, et al. (2011). "Interpersonal Influences in the Scale-up of Male Circumcision Services in a Traditionally Non-circumcising Community in Rural Western Kenya." Global Journal of Community Psychology Practice 1(3).

Shell-Duncan, B. (2001) The medicalization of female “circumcision”: harm reduction or promotion of a dangerous practice? Social Science and Medicine 52:1013-1028.

Also, if you are a scholar, MIT Open CourseWare lists tons of anthropology course syllabi and reading lists! 

Another Semester Down

Another semester down...

So I've found that I can hold down 2 part time jobs, doula work, a full grad course-load including 3 group semester-long projects, and not go totally insane. I still managed to get all A's and see my friends at least once a week for dinner. My wonderful SO was there to help me through the emotional breakdowns (I didn't say there weren't any!), and I managed to come out alive. I'm quite proud of myself! This semester was very hard and I'm so glad its over.

I had two fantastic doula clients give birth in the same week. Though it totally messed up my sleep and homework life that week, I thoroughly enjoyed helping both these wonderful families. Here is some of what I experienced and learned:

One was a primip who had switched to a birth center birth during her pregnancy. The birth center was big and beautiful and totally empty while we were there. I was with her and her husband for 24 hours at home and the birth center before the decision was made to transfer to a hospital so mom was able to get some pain relief and some sleep. She had been awake for nearly two days! First time moms never follow this advice which I always give, but you really have to sleep in early labor! She was such a trooper - she would have kept on going if she wasn't just so tired. Really such a sweet couple, great midwife and midwives' assistant at the birth center, and a seamless transfer to midwifery care at a nearby hospital. The transfer was very upsetting, and she did reverse some in dilation. I've heard of this happening before and I'm very sure this is what happened here. It was a beautiful labor that ended up being an asynclitic occiput posterior baby giving her so much trouble! (I learned at this birth that the baby can be OP and the mom might not have back labor). 

The second labor was the fastest dilation I've ever seen - another primip who I didn't end up laboring at home with because her husband was very nervous in early labor and insisted they go to the hospital. I met them there and the labor was great - very quiet, calm, peaceful. Very few nurses or doctors bothered us the whole time. Mom, dad and I slept on and off in between contractions. There was also some salsa dancing! I really think this may have been partly responsible for such a quick labor - She actually dilated 5 centimeters in about 2.5 hours. I was definitely jaw-drop shocked when I heard she was complete. I've never seen that before!

Recently I've been contacted by two potential doula clients who are very early in their pregnancies. I've never been hired by someone so early in a pregnancy! So I'm having a lot of doula firsts recently.

Next year I'm going to begin earning my continuing education credits for eventual re-certification... Best to start early! Next year will also be the year I start my internship, data collection and thesis writing. Whew!

Happy Holidays, everyone!

Childbirth/Breastfeeding Day in Anthropology

I apologize for the slow down in posting... Grad school and doula work is taking up all of my time this semester! But I will be able to catch up on everything during holiday time, so please stay tuned!


So that fabulous reproductive health anthropology class that I mentioned? Well we had our unit on childbirth and breastfeeding - my favorite day! Naturally, this is the day I chose to help facilitate the discussion for, so I have a little more information on this topic for you.


Our readings on Birth were:

Brunson, J. (2010). "Confronting maternal mortality, controlling birth in Nepal: The gendered politics of receiving biomedical care at birth." Social Science & Medicine 71(10): 1719-1727.

Notes:

 "Universal hospital deliver also may be inappropriate given the desires and/or economic  limitations of community members"

"The concept of birth preparedness, like prenatal care, is a part of a biomedical model and risk framework; when birth is considered a natural event, it does not require planning."

"this study's major contribution is a detailed description of the gendered and household politics that determine whether a woman receives biomedical care at birth."

"By using the term 'natural' I do not intend to invoke a romanticized vision of low-tech, 'traditional' birth as the ideal form. Nor do I mean to equate a 'natural' view of birth with a purely biological view of it... Rather I am referring to a worldview involving a cosmic order in which many aspects of life are seen as beyond human control (although efforts or propitiations may be made in an attempt to influence outcomes) as opposed to the mechanistic materialism of modern science that rejects an ordered cosmic totality and instead articulates the world in terms of cause and effect..."

"Women were socialized to keep quiet about their suffering, was usually men who made decisions such as determining at what point situations were dangerous or life-threatening enough to warrant taking them to the hospital."

"More research needs to be done on possible factors that discourage families from delivering in hospitals, in particular the obstacles for impoverished families such as intimidation or cost."

• What are the limitations these women face in having a safe and healthy birth? What factors influence a Nepali woman to birth where she does?
• Would planning for a birth, in any way, mean that birth would no longer be viewed as a natural event? Is a planned-for birth necessarily a biomedical event?
• In order to reduce maternal mortality, Bruson asks, who ought to control birth? Who should be the advocate?

Miller, A. C. (2009)  "Midwife to Myself": Birth Narratives among Women Choosing Unassisted Homebirth. Sociological Inquiry  79,1: 51–74.

Notes:

"Despite this clear reliance on midwifery, use of a midwife is seen as inappropriate. From the UC perspective, midwives and doctors are 'the same'... professionals who interfere with a woman's natural ability to experience completely unhindered birth. When a birth attendant is present, UC advocates argue that women cease to rely on the inner 'primal' knowledge that exists to guide them through the best, safest, and most empowering birth possible."

The authority of the biological construction of pregnancy and birth indeed reflects what Foucault described as 'bio-power.'"

These women already believe that birth isn't medical, dangerous, etc - "A fundamental rejection of the biomedical discourse on birth."

"The assumption, whether accurate or not, is that when a midwife enters the home she becomes 'in charge'"

"the natural role of husbands as decision-makers"

The professional birth attendant has been rejected, but the framework remains, gesturing to the power of the midwifery model as the primary counterdiscourse to the biomedical construction of birth. 

• In what way is choosing unassisted childbirth a privilege?
• Where does the authoritative knowledge lie in unassisted childbirth?

Piperata, B.A. (2008) Forty days and forty nights: A biocultural perspective on postpartum practices in the Amazon. Social Science &Medicine 67: 1094–1103.

 Notes:

"In the eastern Amazon the immediate postpartum period is referred to as resguardo, lasts for 40-41 days and includes food taboos and work restrictions."

"Quantitative and qualitative data on dietary intake and energy expenditure were collected on 3 consecutive days in each of three postpartum periods."

"women responded by saying 'the boy pulls more' meaning the boy places more strain on the mother... a male infant puts more pressure on a woman's body in terms of breastfeeding style and by causing greater pain an hardship during parturition. The implication is that women require more time to recuperate after the birth of a boy."

"The taboo status of foods was not unanimous... what was taboo for one may not be for another."

"The seduction of the river dolphin"

"During resguardo energy expenditure in physical activity was lower, reducing women's energy needs and allowing them to devote more time to infant care. However, energy intakes were also lower. The reduction in dietary intake was impacted more by work restrictions and the loss of women in subsistence tasks during resguardo than by adherence to food taboos."

• Why is the biocultural framework useful in this study?
• Thinking about the three articles on birth, what effects to gender roles have on the experiences of parturient women?

Our readings on Breastfeeding were:

Gribble, K. D., M. McGrath, et al. (2011). "Supporting breastfeeding in emergencies: protecting women's reproductive rights and maternal and infant health." Disasters 35(3): 

Notes:

"Reproductive rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so..."

"Mothers and infants are vulnerable groups that are disproportionately affected by emergencies and the negative ramifications of breaching these rights are enhanced in emergency conditions."

"breastfeeding reduces women's physiological responsiveness to both physical and emotional stress...artificial feeding increases the resources needed and the work associated with caring for an infant."

The undermining of breastfeeding rights in emergencies

"Supplying breast-milk substitutes to women as a precautionary measure, in the event that they produce insufficient milk, also undermines their confidence in their ability to breastfeed."

• Why is breastfeeding a reproductive right?

• In what ways is this right undermined in both emergency situations and non-emergency situations worldwide? What are the results?

Kukla, R. (2006) Ethics and Ideology in Breastfeeding Advocacy Campaigns. Hypatia 21(1): 157-180.

Notes:

"As a result, many of our public health initiatives specifically target mothers' choices, as though these were morally and causally self-contained units of influence; if only we could talk women into making the right choices, these initiatives presume, then children would turn out healthy"

"The fact that mothers are not behaving as they are being called upon to behave is here smoothly interpreted as empirical proof that they are no actually hearing the call. Such an interpretation closes down any interrogation of why women might not behave as they are asked to, even if they hear and understand the request."

"One might have assumed that what makes the United States saliently different from all other developed nations with better breastfeeding rates is not its lackluster advertising campaigns, but rather its abysmal maternity leave policies, privatized daycare system, complete absence of workplace regulations supporting breastfeeding, and so forth."

"It utterly fails to examine or address the reason for this gap between message and behavior, insistently keeping the focus on changing women's choices... We need to question our assumption that improper education is the cause of low breastfeeding rates."

There are many American women, especially women from the socially vulnerable groups least likely to breastfeed, for whom breastfeeding is not in fact a livable choice..."

"Breastfeeding mothers are asked to negotiate an exceptionally complicated set of codes of privacy and publicity."

"...in comparison with mobile, privileged white women whose bodies do not challenge normative conceptions of femininity" 

"As a culture, we expect and demand that breastfeeding be contained within the domestic space..."

In ads, mothers are portrayed as white women, garbed in bedroom clothing, sitting in a nursery or a nonspace, the women look down at their infants, the children are never older than 1, etc.

Really interesting section on the sexual texture of breastfeeding... "position the infants as traditional male sexual conquerors" 

"When we hide the real, deeply culturally embedded barriers to safe, comfortable breastfeeding, we tell mothers who face these barriers that they are unmotherly, shameful, incapable, defective, and morally inadequate/ We then combine this with the message that breastfeeding their child is the only decent choice, the only way of refraining from harming their children, and their responsibility as mothers."

• The U.S. DHHS breastfeeding advocacy campaign fails to take into account societal and policy level issues related to breastfeeding barriers, focusing only on the assumed rational behavior of individual mothers. What effect does this have on breastfeeding rates?
• What do the "Breast is Best" and "Babies were Born to Be Breastfed" campaigns mean for the "good/bad mother" debate?
• Kukla argues that "the reasons women 'fail' to breastfeed go not only well beyond selfishness or lack of education, but even beyond physical and economic barriers such as cracked nipples and long work hours. These reasons lie buried deep within our culture..." How is breastfeeding culturally situated, and how can the cultural context be altered?

Non-normative bodies and various breastfeeding campaigns (click to enlarge):

Breastfeeding outdoors, in work clothing, not looking at baby, as a woman of color, breastfeeding twins, in an airport, in front of family, in front of strangers, with tattoos, breastfeeding toddlers, and other kinds of breastfeeding campaigns

I had been trying to find this image before class and couldn't, but now I have it so I'm sharing it:

We also touched on laws protecting breastfeeding in the U.S.: 

Our professor also invited some perinatal loss doulas to come and speak about the support that they provide for women experiencing fetal loss, choosing to terminate a pregnancy, or giving birth to a stillborn baby or baby that is not expected to live past birth. This was very interesting, as I had heard of Full Spectrum Doulas before providing doula support during abortions, but hearing the accounts from these doulas about how they work with mothers and families experiencing various forms of grief was incredible. They are usually called by the hospital health care workers directly when a family finds out about their baby's condition, and they provide information and psychosocial support, as well as physical labor support, in addition to photography, footprint mementos, and so on for families that desire them. These ladies have very big hearts to work with family after family experiencing the loss of a wanted pregnancy.




Further reading/watching:

• Canar, Ecuador: Birth and Indigenous Identity in the 21st Century - video preview of an anthropologist's documentary that touches on medical pluralism and birth
• Breast-Milk for Haiti: Why Donations are being Discouraged, Jan 29, 2010 - an article about the difficulty of sending breast milk donations to Haiti after the earthquake
• Breastfeeding Legislation and Policy, United States Breastfeeding Committee
• Best for Babes Foundation - dedicated to beating the Booby Traps, the cultural and institutional barriers that prevent moms from achieving their personal breastfeeding goals 
• Born Free: Unassisted Childbirth in North America - Dissertation by Dr. Rixa Freeze, department of American studies (2008) - Rixa herself had a planned homebirth, a planned unassisted birth, and an unplanned unassisted birth
• Birth in Four Cultures: A Cross-Cultural Investigation of Childbirth in Yucatan, Holland, Sweden and the United States by Brigitte Jordan (1992) - the mother of anthropology of reproduction, anthro of birth, and the concept of authoritative knowledge
• Medical Anthropology Quarterly, June 1996 10(2) - a full issue on authoritative knowledge and birth
• Monique and the Mango Rains: Two Years with a Midwife in Mali by Kris Holloway (2006) - a quick read by a young peace corps worker about her experience with reproductive health issues in Mali

Anthropology of Reproductive Health: Part 2

This is the second part in my sharing of my Anthropology of Reproductive Health graduate course topics and readings.

This semester I am taking a fabulous anthropology course on reproductive health. With topics like state control/social control, pregnancy/prenatal care, childbirth/breastfeeding, abortion, infertility, STI's, and circumcision, what's not to love?

So, I thought I'd list the articles we've been reading so that you can read them, too, if interested. My professor has compiled an excellent reading list, and I hope she doesn't mind that I'm sharing them here. I will do this in parts, so as not to overwhelm anyone interested in seeing the full list, and I am including some notable quotes from some of the articles to give you an idea of what I found most interesting about them.

Our third class was dedicated to the topic of State Control/Social Control, and we touched on the following issues:

Medical Accuracy in Sexuality Education: Ideology and the Scientific Process. Santelli, J. (2008)

"The Waxman Report found that 11 of the 13 curricula [of commonly used abstinence programs] contained false, misleading or distorted information about reproductive health, including inaccurate information about contraceptive effectiveness and the risks of abortion, among others."

"Withholding potentially life-saving information from sexually active adolescents is ethically troubling. The principle of informed consent suggests that persons should be given all the information they need to make informed choices."

Counseling Contraception for Malian Migrants in Paris: Global, State, and Personal Politics Sargent, C. (2005)

"Sub-Saharan Africans had the highest fertility among foreigners living in France in 1999, with an estimated 4.72 children per woman, in contrast to 1.72 children born to mothers with French nationality."

"An implicit hospital policy opposes immigrant births and strongly encourages contraception."

"The prescription for the pill may be added to the stack of prescriptions a woman receives at discharge, without explanation."

"The predominant perspective among our informants was that Islam opposes contraception. In fact, Muslim jurists and theological texts demonstrate ambivalence regarding birth control."

Unintended consequences: Exploring the tensions between development programs and indigenous women in Mexico in the context of reproductive health. Smith-Oka, V. (2009). [I've read this before for another class; it seems to be an important one]

"Reproductive rights are culturally and historically located."

"I use a political economy framework to explore how seemingly innocuous programs, such as cash transfer policies, shape women's reproductive choices... My purpose includes the following: a. to examine women's perceptions of forcible interactions and the medical staff's use of insistence and a joking relationship to implement policies; b. to show how the implementation of development programs often goes awry on the ground; and c. to illustrate the intersections between medicine, economic development, and the state on women's reproductive freedom."

"Their knowledge about health and their bodies carry less weight than the knowledge of the medical personnel. In these contexts their knowledge becomes discredited and devalued in the light of the authoritative knowledge of doctors and nurses."

Sterilized in the name of public health: race, immigration and reproductive control in modern California. Stern, A.  (2005) 

"California defined sterilization not as a punishment but as a prophylactic measure that could simultaneously defend the public health, preserve precious fiscal resources, and mitigate the menace of the 'unfit' and 'feebleminded.'"

"foreign-born were disproportionately affected, constituting 39% of men and 31% of women sterilized."

"African Americans constituted just over 1% of California's population, they accounted for 4% of total sterilizations."

"California's sterilization program was propelled by deep-seated preoccupations about gender norms and female sexuality...the sterilization of women and young girls categorized as immoral, loose, or unfit for motherhood intensified."

"Sterilizations were particularly pushed on women with 2 or more children who underwent cesarean deliveries."

The social life of emergency contraception in the United States: disciplining pharmaceutical use, disciplining sexuality, and constructing zygotic bodies. Wynn, L and J. Trussle. (2006)

This article examines the FDA hearing on the proposal to permit nonprescription access to the Plan B emergency contraceptive pill. The arguments of those who came to testify for or against it are laid out and analyzed. Some of the reasons I highlighted in my text were "doctors would lose key opportunities to talk with their patients about contraception, sexual decision-making, and the risk of sexually transmitted disease" (which I've never had a doctor do, and would require women to pay not only for the pill, but also the doctor's office time, not to mention is an unequal power relationship), portraying Plan B, but not Viagra, as facilitating the sexual exploitation and seduction of women, contestations of zygotic personhood (not fetal personhood, but actually zygotic prior-to-implanation personhood), and more. Great article!

"Political debates over new medical technologies, especially new reproductive technologies, are not so much debates about science and technology as they are centrally concerned with interpreting these technologies within a web of (sub)culturally defined moral valuations and social interpretations."

 "Because the contraceptive effect of breastfeeding may operate by preventing the implantation of the fertilized eff, should the merits of breastfeeding be rethought in the name of human (zygotic) life, or should female sexuality be avoided during lactation? Because half of fertilized eggs never implant, should more respect be given to the menstrual blood of sexually active women that most Americans dispose of unceremoniously in tampons and other sanitary protection products?"

The following fabulous articles consider issues regarding Pregnancy/Prenatal Care:

Ethics: ‘‘Life Before Birth’’ and Moral Complexity in Maternal-Fetal Surgery for Spina Bifida Bliton, M.J. (2003)

The Production of Authoritative Knowledge in American Prenatal Care Browner, C.H. and N. Press (1996)

"Patients are active interpreters of medical information. They pick and choose, using and discarding advice according to internal and external constraints and considerations. In our case of pregnant informants, embodied knowledge and everyday life exigencies proved to be pivotal in their selective designation of certain biomedical knowledge as authoritative."

"Valuing information about prenatal care derived from embodied knowledge over that of biomedical knowledge contrasts with the attitudes and behavior that characterize most American women as they give birth. During labor American women are highly acquiescent to biomedical authority at the expense of embodied knowledge."

God-sent ordeals and their discontents: Ultra-orthodox Jewish women negotiate prenatal testing. Ivry, T., E. Teman, et al. (2011).

"Ethnographies of reproduction teach us that a religion's formal attitude to a certain technology may be notably unrelated to its practical use... being religious does not always mean refusal [of prenatal diagnosis]."

"Carrying and raising an unhealthy child is a task God might assign a woman to test her faith... women in our study constantly prayed not to be she whom God chose for such an ordeal."

"Nearly all the women could recall at least one story of another woman getting rabbinic permission to terminate a pregnancy that was life-threatening or after lethal anomalies were detected."

Interrogating the dynamics between power, knowledge and pregnant bodies in amniocentesis decision making. Markens, S., C. H. Browner, et al. (2010) 

"A common assumption is that women who decline prenatal testing distrust biomedicine and trust embodied/experiential knowledge sources, while women who accept testing trust biomedicine and distrust embodied/experiential sources. Another major assumption about prenatal testing utilization is that women who are open to abortion will undergo prenatal testing while those who are opposed to abortion will decline testing."

"'Should a pregnant woman do everything doctors advise?' 'No, they may be wrong too, you never know.'"

"'What is to guarantee the doctors know? They are human beings, and they make mistakes too... while pregnant you need to get as much advice from them [as possible], but also not to believe in everything.'"

"It is important not to view biomedical and other knowledge sources as inherently in opposition - many women see various source as powerful, valid and useful. In other words, accepting biomedical knowledge implies neither passivity in the face of technology not a necessary distrust of experiential knowledge sources."

"In our study, Mexican-born women were much more likely than the US-born women to both believe that they can 'tell' if the baby is fine and to believe it's important for pregnant women to do everything doctors advise."

Perils to Pregnancies:On social sorrows and strategies surrounding pregnancy loss in Cameroon. Van Der Sijpt, E. and C. Notermans (2010) 

"Pregnant bodies have been predominantly homogenized, politicized, and medicalized."

"Spontaneous losses are often suspected to be provoked; induced abortions are often presented as spontaneous ones."

"Local notions of loss are thus not only more encompassing and diverse than assumed in global debates, but they also require strategic values that cannot be understood if not situated within local atmospheres."

Do these quotations spark any feelings or considerations? Have you read these articles? Please share your thoughts!

Anthropology of Reproductive Health: Part 1

This semester I am taking a fabulous anthropology course on reproductive health. (I actually told my class that I have this blog, so if you are my classmate, hello!) I am enjoying this class more than any other class I've taken so far in graduate school - the discussions each week are excellent and I want them to continue all day, the reading assignments are fascinating and I enjoy every one, and the overall class theme is issues related to sexual and reproductive health from a multi-disciplinary approach! With topics like state control/social control, pregnancy/prenatal care, childbirth/breastfeeding, abortion, infertility, STI's, and circumcision, what's not to love?

So, I thought I'd list the articles we've been reading so that you can read them, too, if interested. My professor has compiled an excellent reading list, and I hope she doesn't mind that I'm sharing them here. I will do this in parts, so as not to overwhelm anyone interested in seeing the full list, and I am including some notable quotes from some of the articles to give you an idea of what I found most interesting about them.

The first day we talked about Reproductive Health and Human Rights, for which we read the articles listed below.

Palestinian Women’s Sexual and Reproductive Health Rights in a Longstanding Humanitarian Crisis (Bosmans, M., D. Nasser, U. Khammash, P. Claeys, and M. Temmermane 2008)

"...the complexity of the Israeli-Palestinian conflict is seriously affecting the sexual and reproductive rights of both refugee and non-refugee women in the West Bank and Gaza."

"Two international organizations mentioned keeping records of deliveries, still-births and cases of women dying during delivery at the military checkpoints because they were denied passage to reach the hospital."

"A woman's contribution to national development and survival is mainly understood in terms of her reproductive role, and persistent gender inequalities prevent her from using contraception."

Sex trafficking, sexual risk, sexually transmitted infection and reproductive health among female sex workers in Thailand (Decker, M. R., H. L. McCauley, et al. 2011)

‘Other Inhuman Acts': Forced Marriage, Girl Soldiers, and the Special Court for Sierra Leone (Park, A.J. 2006) 

"Girls should not be subsumed under the category 'women' or 'children', but require specific attention."

Advancing Transgender Family Rights through Science: A Proposal for an Alternative Framework (Sabatello, M 2011) 

"As not 'truly' man or woman, their right to marry was extremely curtailed. As not 'naturally' mother or father, their right to found a family could not reach the legal threshold for 'parenthood.'"

"While transgendered individuals were offered the advantage of scientific developments, exercising this option meant losing an array of other fundamental human rights."

Behind Closed Doors’: Debt-Bonded Sex Workers in Sihanoukville, Cambodia (Sandy, L. 2009) 

Our second class was devoted to the topic of Anthropology and Reproduction:

Anthropology theorizes reproduction: Integrating practice, political economic, and feminist perspectives. Greenhalgh, S. (1995) 

“Life Begins When They Steal Your Bicycle”: Cross-Cultural Practices of Personhood at the Beginnings and Ends of Life. (Morgan, L. 2006) [my favorite article of this week!]

 "Feminist anthropologists have asked, for example, how 'fetal subjects' have come to acquire social currency, and who is able to assert of deny their moral significance."

"Wari' [people in western Amazonia] models of personhood emphasize bodies that are interconnected; each individual's body is constituted through the continual exchange and incorporation of body substances such as blood, semen, breast milk, and sweat. Furthermore, one's identity changes throughout one's life as one becomes more or less related to multiple others through the exchange (or not) of body substances. When Conklin asked the Wari' to explain how babies are made, tey told her that a newborn is built from the gradual accumulation and mixing of the father's semen and maternal blood over the course of pregnancy. If a father goes away for an extended period of time while his wife is pregnant, the baby will be born thin and weak because it was deprived of the semen it needed to make it strong. Conklin explained that for the Wari', this conceptualization implies that babies are always considered to be the product of a sustained relationship between a man and a woman...A Wari' pregnancy therefore can never be a mistake; a Wari' child can never be 'unwanted.'"

 "I fear that the concept of culture has sometimes come to function as what anthropologist James Ferguson called an 'anti-politics machine,' an ideological apparatus used to divert attention away from structural inequalities that might be harder to change, or the questioning of which would threaten to destabilize the political system."

"A focus on fetal citizens diverts attention from other challenges that pregnant women face and from other threats to fetal health."

"Nor will personhood be resolved in the embryology laboratory or in the courts, for personhood is destined to be played forever on the disputatious fields of social practice."

Liminal Biopolitics: Towards a Political Anthropology of the Umbilical Cord and the Placenta. Santoro, P. (2011).

"Preserving UCB [umbilical cord blood] is offered as a form of engaging with biomedical evolution and with the whole new generation of stem cell therapies that will surely be developed in the near future."

In early Modern Europe, "the placenta simply could not be neglected: the child's future career depended on it, because the child inevitably suffered form the repercussions of any misadventure on the part of his double."

"[The placenta] was tied to the branch of a tree and left there to dry, or cooked and eaten by the mother and maybe other people (the belief being that the placenta had miraculous powers of fertility)." 

"Among the Cherokee, the navel-string of a girl is buried under a corn-mortar, in order that the girl may grow up to  be a good baker; but the navel-string of a boy is hung up on a tree, in order that he may be a hunter... In ancient Mexico they used to give the navel-string to soldiers, to be buried by them on a field of battle, in order that the boy might thus acquire a passion for war."

"A negligent disposal could be the source of directly disastrous events: if one burned the placenta in the fire, it was possible that the mother would suffer from fevers and inflammation of the womb..." 

"The Santals of East India, for instance, do not refer to their birthplace, rather they refer to 'the village where my afterbirth is buried'"

Culture, Scarcity, and Maternal Thinking: Maternal Detachment and Infant Survival in a Brazilian Shantytown. Scheper-Hughes, N. (1998)

"Infant and childhood mortality in the Third World is a problem of political economy, not of medical technology." 

"Whenever we social and behavioral scientists involve ourselves in the study of women's lives - most especially thinking and behavior surrounding reproduction and maternity - we frequently come up against psychobiological theories of human nature that have been uncritically derived from assumptions and values implicit in the structure of the modern, Western, bourgeois family. Theories of innate maternal scripts such as 'bonding,' 'maternal thinking,' or 'maternal instincts' are both culture and history bound, the reflection of the very specific and very recent reproductive strategy: to give birth to few babies and invest heavily in each one."

Feminist Anthropology Anew: Motherhood and HIV/AIDS as Sites of Action. Downe, P. J. (2011)

Check back for more soon!

Recent Doula Happenings

Whew! The summer is almost winding down for me, as my summer classes have ended and my fall classes start in a couple weeks. In grad school news, I have completed all my tedious required public health courses (hooray!) and can really get into the meat of my MCH degree. In Anth, I will be taking a biocultural medical anthropology course again this semester and I am thrilled!

In my doula world, I have had an eventful summer and a lot of "doula firsts" (the learning never stops!):

I was a doula for a friend, which was much more emotionally challenging than I ever could have imagined. I was a doula at the same hospital twice (the first time that has happened to me, believe it or not), with two very different experiences. I had my first extremely negative doctor-doula experience. I had a really excellent doctor-nurse-doula experience and a beautiful natural birth! I had my very first doula client cesarean section. I was paid full price for my doula services for the very first time. I went to a prenatal visit to the obstetrician office with a doula client for the first time. I had to return to a hospital within 8 hours of a birth to help with breastfeeding because a client still hadn't seen a lactation consultant. I was called to do back-up for another doula for the very first time. I labored at home with a VBAC mom for the very first time. I was at a hypnobirth and saw a mama walking and talking through 3.5 min apart contractions! I learned that sometimes what I would fear most is not what my client would fear most. I prepared a vegan postpartum meal for the first time.

Every woman, every labor, every birth are so different and I learn something from every one. Sometimes I mess up and I lay in bed at night dwelling on what I could have done differently. Sometimes people say really wonderful things that just stick with me and make me feel great about what I do!


I also finally heard back from DONA about my doula certification packet, which I sent in over two months ago. The reviewer finally received it, contacted me to let me know, and has already called me to discuss it. Turns out DONA is ridiculously nit-picky about their paperwork! If its required for them to be this way (and not just my luck of the draw), than I definitely do not what to be on the certifying committee! My reviewer is very nice, but she is asking me to go through my charts and make sure I write or check "no" as well as "yes," not just leave some blank, "so I know I didn't just forget to check something," and then scan and send her a new copy. Also, make sure you have every form of contact possible for everyone on your resources list, fellow certifying doulas, because I am being made to return to my list and find all such information.

I'm not worried that I will be certified (she said all my references has great things to say about me and all my essays are in order), I'm just made to wait to correct silly bits of paperwork. Sigh. They truly do a very thorough job, though - she was almost giving me an oral quiz about information I had written in my essays, i.e. "what can you do in the future so that your client feels differently?" or "why do you think she felt this way about that?" etc. Another thing I noticed when she was having some trouble pronouncing my client's last names was that all my certifying birth clients were from different ethnic backgrounds! Awesome!


Two more great things happened this summer - 1. I became involved with a breastfeeding task force in my county. It is a collaborative of public health workers, health workers, lactation consultants, researchers, and so forth who are working together to increase breastfeeding rates in our county, especially among low-income and minority groups. 2. I have also become involved with a local public health organization that received a grant from the March of Dimes focusing on their "Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age" in order to prevent premature births. I'm working on program planning and program evaluation. I'm excited to be involved!


I have a client currently, and will be on-call during the beginning of the semester, but was thinking of just being a back-up doula for most of my fall semester (which has become exceptionally busy). Unfortunately, I have been receiving inquiries for doula services! I know I should turn them down but its just so tempting... Do any of you have experience or advice about being a doula while taking a full load of graduate school courses and working? Advice would be greatly appreciated! :)

  

Back in the Birth World

It has been months since I've really felt like a doula. My summer and fall of moving a lot and starting graduate school had me on an extended hiatus. Although I kept a connection to all things birthy through this blog and keeping up with my favorite online blogs, I haven't really felt as much a part of the birth world as I did last spring.... until this week! And I'll tell you why.

Since moving here I have had a couple failed attempts to do some birth networking. It is very slow-going. I did meet a couple doulas at a maternal and child health meeting, which was nice, but they told me there was no nice doula network in Tampa because although there were many doulas, they are apparently quite divided (home birth only/extremely anti medical vs supportive of hospital/medical options). But thanks to the wonders of the internet, I met a really great local doula through our blogs! She followed my blog and when I checked out hers I realized she was local and we decided to connect in real life!

She invited me to attend a weekly prenatal class given by a nearby pregnancy help center. It is a small weekly class that is given for free to women no matter what age they are or what number pregnancy or child they are having. She and I had a really great time getting to know one another, and it was so fun to just babble on about birth and breastfeeding with someone who shared my interests! The class was also really great - it is so interesting to see what is being taught to (what I interpreted as) low income, mostly minority pregnant women and how it is discussed. The discussion was great and I loved listening to what everyone had to say. The women all had diverse experiences and input. We learned mainly about nutrition during pregnancy, and then we had a nutritious dinner together. I had a great time and I got to hold an adorable fat baby!

If you are reading this, my new doula friend, hello! :)

In addition to the above, I also attended a really great maternal and child health symposium at my college of public health with really awesome and diverse speakers. The main topic tended to be preterm birth prevention and the role of obstetrical management in the late preterm period.

Some things I learned which I will share with you -

• The Big 5 states (Florida, Texas, Illinois, New York and California) account for 38% of births and 40% of total Cesarean sections in the country.

• There is a huge initiative to reduce elective deliveries before 39 weeks at hospital, health system and statewide levels. Past and current initiatives have been shown to be create effective change if physicians are held accountable, nurses were empowered and guidelines were enforced. 

•  Why are non-medically indicated (elective/planned) deliveries increasing in frequency?

• advanced planning
• mother lives far away and/or has a history of quick labors
• wants baby delivered by her doctor and no one else
• maternal intolerance to late pregnancy (ie backache, indigestion, insomnia)
• prior bad pregnancy/birth outcome (ie stillbirth)
• and...

• Women's birth perceptions regarding the safety of births at various gestational ages - study found that majority of women think that baby is at term after 37 weeks (ITS NOT!!) and many thought that even after 35 weeks it was OK

• Ultrasound for measuring the baby's weight can be 1-1.5 lbs off

• Inducing early does not lower risk of macrosomia, preeclampsia, or lower stillbirth rates
• Fear with macrosomia is shoulder dystocia - early induction does not reduce risk of shoulder dystocia

• Complications of Non-medically indicated deliveries between 37 and 39 weeks:
• increased NICU admissions
• increased transient tachypnea of the newborn
• increased respiratory distress syndrome
• increased ventilator support
• increased suspected of proven sepsis
• increased newborn feeding problems and other transition issues
• Morbidity rates double for each gestational week earlier than 38 weeks

• Timing of Fetal Brain Development: cortex volume increases by 50% between 34 and 40 weeks gestation, brain volume increases at a rate of 15mL/week between 29 and 40 weeks gestation
• A baby's brain at 35 weeks weights only 2/3 of what it will weigh at 39-40 weeks.

It is just great to be in a room where everyone is discussing things like "episiotomy rates in primips" and so forth. It all made me really excited to be both studying and working for better births.

It feels awesome to be back in academia, and back in the world of birth!

Graduate School

Hello! Long time no see!

I apologize that moving and graduate school has taken over my life for the past couple weeks. I have had very little time to keep up with my blogs and the blogs of others! But now I am all moved-in and my classes have begun, so I am hoping to find my routine and be able to update this blog a little more regularly.

So far the program (dual MA Anth and MPH) is going well. Its exciting to be back in the university world and so much fun to be studying Anthropology again. I am also learning a lot about Public Health which is thrilling. There are a ton of subfields that I never knew about, and though there aren't a plethora of students and faculty working on birth-related research, there are some. It is going to be so awesome to hook up with people who are also interested in studying cultural perceptions of breastfeeding, the medicalization of birth, etc etc and just talk and talk with them!

I've nearly decided to do a Biocultural Medical Anthropology concentration for my Anth degree. I've also begun my Graduate Assistantship helping organize a Maternal and Child Health Training Grant. 

I'm the only doula I've come across (surprise surprise) but not the only one interested in prenatal and postpartum health issues, which is great. I haven't begun majorly advertising my doula services in this area yet, because I'm hoping to get a feel for my graduate program this first semester.

Thanks for following along!

What is Medical Anthropology?

As noted on my "About Me" page, I am an aspiring Medical Anthropologist. I have always loved Anthropology, in various form, even before my university days. I loved reading prehistorical fiction novels, like a big nerd, even in middle school. I know a lot about how ancient tools were made, canoes were built, and animals were domesticated by early peoples. I know what animals they hunted and how they built their homes.

In college, Anth courses were definitely my favorites, and I learned a lot about socio-cultural anthropology. Cultural anthropology is what I focused on for my senior honors thesis, and I loved conducting ethnographic field world abroad. 


(Ethnography: A research method of the social sciences in which data collection is often done through participant observation, interviews, questionnaires, etc. Ethnography aims to describe the nature of those who are studied.)

But my most recent passion is, of course, birth culture. So, naturally, I'd love to combine my love of birth, breastfeeding, women's health, pregnancy, and so forth, with my love of cultural studies. And that is what I am working towards. 

The combination of cultural studies and women's health, is, in effect, my intended area of medical anthropology.

The Society for Medical Anthropology, of which I am a member, defines Medical Anth: 

Medical Anthropology is a subfield of anthropology that draws upon social, cultural, biological, and linguistic anthropology to better understand those factors which influence health and well being (broadly defined), the experience and distribution of illness, the prevention and treatment of sickness, healing processes, the social relations of therapy management, and the cultural importance and utilization of pluralistic medical systems. The discipline of medical anthropology draws upon many different theoretical approaches. It is as attentive to popular health culture as bioscientific epidemiology, and the social construction of knowledge and politics of science as scientific discovery and hypothesis testing. Medical anthropologists examine how the health of individuals, larger social formations, and the environment are affected by interrelationships between humans and other species; cultural norms and social institutions; micro and macro politics; and forces of globalization as each of these affects local worlds.

Medical Anthropology research tends to have enormous potential to be turned into implementing community health programs. "Local and qualitative ethnographic research is indispensable for understanding the way patients and their social networks incorporate knowledge on health and illness when their experience is nuanced by complex cultural influences," it says on Wikipedia. 

Thus, Medical Anth is often strongly connected with the field of Applied Anthropology. Applied anthropology refers to the application of method and theory in anthropology to the analysis and solution of practical problems. Applied Anth applies anthropological research to contemporary issues. For instance, with a health slant, a research project on how cultural factors influence the spread of HIV. This has a lot to do with another field that also researches and implements change in health, Public Health. 

I hope that I explained all the intersections well, in an attempt to explain the dual degree Applied Anthropology and Masters of Public Health Program I am starting in the fall.

What is Public Health?

Public Health Doula recently wrote a whole post explaining public health, part of which I have copied here, because it is a great explanation:

What is public health?
- Public health deals with populations, rather than individuals

- So public health professionals tend to work on programs, policies, administration, and research - not with personally delivering services to individuals

- Public health focuses much more on prevention than on treatment

I can't speak to all programs, particularly more technical ones, but I think I can safely say most MPH programs generally aim to equip you with a good understanding of how diseases and health conditions occur on a population level. Other focuses can be on how to administer public health programs (e.g. a vaccination campaign) and how to monitor and evaluate those programs (e.g., devise a plan to make sure that the vaccination campaign is reaching the populations it was targeting, and then assess whether it made a difference on vaccination rates in those populations, and whether the difference was big enough to justify spending all that time and money). They may also cover particular content areas (e.g. courses on epidemiology of infectious diseases, or an overview of HIV globally) or skills (e.g. advanced statistical modeling techniques).

A master's in public health is more practice-oriented than research oriented (versus a doctoral degree in public health) - generally considered a "professional degree" like, for example, a master's in social work. While some people in an MPH program may be there as a stepping-stone to a doctoral degree, most are there to go right back out into the workforce. So a master's program generally will have less emphasis on research and more on practice. This isn't to say that MPH grads don't go on to do research, but they also go on to do a huge range of other types of work.

The area I am focusing on in Public Health, so that I can study maternity care and breastfeeding, will be Maternal and Child Health.

Maternal and Child Health:
Providing information and access to birth control; promoting the health of a pregnant woman and an unborn child; and dispensing vaccinations to children are part of maternal and child health. Professionals in maternal and child health improve the public health delivery systems specifically for women, children, and their families through advocacy, education, and research.

So one day I hope to be able to use these forthcoming degrees to bring about positive change in the areas of public health, and eventually enter a PhD program to become a Medical Anthropologist. 

Graduate Acceptance!

Dear Emily:

Congratulations, I am pleased to inform you that you have been accepted into the Masters Program in Applied Anthropology. This year we had a high number of very competitive applications and, as always, have selected only the very best students.

Congratulations again, we look forward to having you as part of our graduate student body.


YAY! :D



In the Anthro department I can choose either a Cultural or Biological track, and in the School of Public Health I will choose between either Maternal and Child Health or Global Health.


One step closer to a PhD!!

MA/MPH here I come! (I hope!)

Hooray! Everything is officially in for my application to graduate school! I am very excited that I found a program that incorporates both medical anthropology and public health in maternal and child health. Now all I can do is sit back and wait for the decision, which probably won't come for another 60 blog posts. haha.