Birthing at the margins: (Re)conceptualizing maternal health care in BC




Vandekerkhove, Melissa Murdock

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Generations of women’s health workers, writers, activists, and academics have tended to present midwifery as the opposite of obstetrics; to summon the appealing association of midwifery by advocating ‘tradition and nature’ over ‘modernity and medicalization;’ and to invoke the melodrama of the subordination of female patients by and to male doctors. This thesis suggests that it is much more productive (and historically accurate) to think of the shifting roles and identities of childbirth practitioners and their clients in terms of “boundary work” rather than the oft-touted dichotomy of domination/resistance. The thesis navigates Enlightenment theories of body and nature and moves to explore the example of the Foucaultian “clinic” to illustrate a relatively unstable foundation on which the biomedical clinic appears not as an entity trapped in time and space, but always already subject to change and negotiation. A discussion of maternal health policy and the roles of birthing women in actively shaping the care they receive brings home the central argument that what is crucial to the ever-developing birthing models is not resisting that which appears to dominate, but affirming a practice that more adequately meets the needs of birthing women in BC today.



maternal health care, childbirth, boundary work theory, midwifery, birthing centres, obstetrics, Foucault, maternal health policy, biomedicine