Monday, December 26, 2011

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!

Friday, December 23, 2011

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!

Tuesday, December 20, 2011

Comment Turned Post: Medical Anthropology and Midwife Rituals

Medical anthropologist and midwife Melissa Cheyney published an article in the Medical Anthropology Quartlerly called Reinscribing the Birthing Body: Homebirth as Ritual Performance. Apparently this caught the eye of a writer at Science 2.0, Hank Campbell, who decided to bash anthropology and midwifery in an article called Midwife Rituals: Anti-Science Or Just Symbolism?

Campbell seems to fail to understand certain things about anthropology, like the fact that participant-observation is a dominant method of anthropological research. He also calls her analysis of her research "advocacy" when she says "Just as women and their doctors who deliver in the hospital often feel convinced that their birth was the only safe and 'correct' way, women and midwives who deliver at home feel strongly that they have the solution." This is her analysis statement, not a bashing of obstetricians. Additionally, calling aspects of biomedical care "rituals" is not meant to "create false equivalence for female empowerment rituals," as Cambell states. It is a true anthropological concept and theoretical analysis method which has been studied extensively, not simply made up for Cheyney's convenience.

It is a true concept that the female reproductive body has become medicalized in all aspects - menstruation, pregnancy, birth, breastfeeding, menopause, and so forth. The concept that American medicine has of the birthing body is encompassed in the culture of biomedicine and the beliefs of our society. We like to think that it is objective, evidence-based, and the One Truth, but in fact it is only one reality. Robbie Davis-Floyd explored how medicine, obstetrics, and birth in the U.S. is a ritual; a socially constructed rite of passage. If Campbell had read the article carefully, he would have noted that the reason that Cheyney used ritualization as a lens through which to explore homebirth is because it has been a useful tool for reproductive anthropologists in the past. (Rites of passage and rituals have been studied extensively in other areas of anthropology as well). Davis-Floyd showed that birth is "a reflection of a larger patriarchal and technocratic society." Davis-Floyd examined the rituals associated with hospital birth, and Cheyney examined the rituals associated with home birth midwifery. Both are valid anthropological research and theory.

So while, yes, home birth is partly about a rejection of the dominant biomedical tenants about birth and certain types of authoritative knowledge, it is also about embracing a different point of view regarding the way birth is or should be. Biomedicine is only one example of the way birth is or can be. Differing views are not wrong, they are just different, and exploring them for a deeper understanding is what medical anthropologists do best.

The point of this article is not to add to the "which is better, home birth or hospital" debate. The purpose is to explore the rituals involved in home birth midwifery and what they mean. Cheyney believes that what she calls rituals in home birth are intentionally subverting technocracy, and are meant to "reinscribe pregnant bodies and reterritorialize childbirth spaces and authorities." What this means is that home birth midwives are doing the things they do and saying what they say in order to purposefully go against the hegemony of biomedicine and all it says about bodies and where birth should take place and with whom. She says that midwives are, like obstetricians, taking advantage of this liminality of birth to create a certain meaning of childbirth (in the midwives' case, that nature is sufficient; in the physicians', that technology is supreme).

Many of the rituals (“patterned, repetitive and symbolic enactment of cultural beliefs and values") that Cheyney describes include things like including the woman and her family in prenatal care, repetitive birth mantras and other techniques for a drug-free birth, an inversion of the doctor-up, mother-down hierarchy during pushing, and certain postpartum techniques like delayed cord clamping. Cheyney argues that midwives do all these things in order to intentially be diferent from the biomedical model. Its interesting to read her description of them as their own form of "ritual," and I also would not have thought previously about their being used to intentionally be subversive.

Some women do "sidestep obstetric standards of care" and challenge "the hegemony and authoritative knowledge of medicalized birthing care" by choosing birth with a midwive at a center birth or at home. While the idea about which is "better" can be debated until the end of time, the point is that women do make that choice, and have the right to. And though it is not a belief shared by all, it is my belief that women have the right to choose what happens to their bodies and who they hire to provide their health care.

I agree that homebirth is a "medium for the promotion of social change," but I don't think thats the only reason that women choose to birth at home or with a midwife. It has been shown that women who choose home birth are rejecting the technocracy, but this is not always a conscious part of their decision. Furthermore, the reason they do it is not always to be part of political and social change, but simply to make the best choice for themselves and their babies, or because they have no other choice (in the case of the underinsured, for example).

These are my thoughts on the article. Unfortunately, the comments on the Science 2.0 article do not tend to focus on the fact that Campbell's understanding of anthropology is flawed and his analysis of Cheyney's piece is incorrect. Many in the comments section jump into the home birth vs. hospital and midwife vs. physician debate. So, I am going to weigh-in a bit here:

It is not just mothers, hippies, birth activists, and midwives who are pointing out that the biomedical model of birth is potentially dangerous, it is also physicians and health researchers and scientists. Birth models that include midwives and the midwives' model of care have been shown worldwide to be birth models that work.

So what's the big deal if women are included in all processes, from conception to birth and beyond? Is it such a bad thing if a woman feels empowered, capable, strong and in control? What's the big deal if a woman wants warm water immersion and positive birth statements repeated to her, if it works? Arguments against home birth midwifery tend to call all this "woo woo" or "touchy feely." Women should be able to have this kind of positive care whether or not you're with a physician or a midwife. It has been shown that it matters and that it is a good thing. So why does biomedicine reject it?

I encourage you to put your two cents in over at Campbell's article, even if you're not an anthropologist. The infamous Amy Tuteur has even found it worth her while to do so! Most commenters seem to agree with what he says, and we need to turn the tide.

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