Abstract
‘There are measurements, analyses, consultations ...“Attend for physiotherapy” . . . “Consult an endocrinologist” . . . “When did you last see the dentist?” And I’ve hardly left the surgery when the phone starts ringing. I know — it’s the clinic again!’ Vera says she has been ill so seldom that she hadn’t any idea that the doctors could be so nagging. ‘I’m not really annoyed, though,’ she grins. ‘I know the doctors have to take care not of me alone, but of both of us.’ (‘Vera, in our office, is expecting ...’, Soviet Weekly, 2 July 1983).
Pregnancy, like other transitional social conditions, is characterized by ambiguity and hence, is open to contrasting styles of management. (Comaroff, 1977, p. 131)
Pregnancy straddles several boundaries simultaneously. Like other reproductive events, it is at the junction of ‘nature’ and ‘culture’, involving a biological process that is accomplished by social beings in particular social settings. It is both an individual and a social process: child-bearing is associated with a‘fixed’ biological person,’ but it is also subject to considerable social manipulation and control. In advanced industrial societies, the major agencies responsible for the social management of child-bearing are the state and the medical profession. As we saw in Chapters 4 and 5, state intervention ranges from protective legislation through maternity leaves to the provision of free antenatal medical care, while medical management is typically experienced as thoroughly pervasive.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
NOTES
New reproductive technologies, such as extrauterine conception (also referred to as in vitro fertilisation or IVF) increasingly challenge our traditional notions which equate child-bearing with one ‘fixed’ biological person. As Rothman (1982, pp. 117–18) points out, ‘it is not yet possible for a human female to avoid pregnancy and still “reproduce,” but it is possible in animals and doubtless will soon be possible for people ... When embryos, or just ova, can be transplanted from one person to another, it is debatable whether the “donor” or the “host” will be considered the biological mother. The donor, the one who mates and conceives, can in one sense be thought of as a biological father; she contributes half of the genetic material, and there her biological contribution ends. Women who are “infertile” becatise they cannot conceive would enter biological motherhood at the point after conception, carrying and birthing transplanted embryos. The mother—host would not be a genetic parent, but there would be a biological tie between mother and child, and social motherhood would begin normally, with pregnancy.’
Graham and Oakley (1981, pp. 51–2) define the concept of a frame of reference as follows: “Frame of reference” embraces both the notion of an ideological perspective — a system of values and attitudes through which mothers and doctors view pregnancy — and of a reference group — a network of individuals who are significant influences upon these sets of attitudes and values.’
Holland and McKevitt (1985, p. 163) argue that a significant proportion — roughly a third — of Soviet pregnant women see no medical specialist during the first trimester of their pregnancy, despite the importance which Soviet doctors attach to the initiation of early antenatal medical care. Soviet studies also show that pregnant women often fail to keep their regular medical appointments and that the most likely group to avoid medical supervision during pregnancy are single mothers.
For the more general advice books, see A Woman = Health + Beauty (Bardo’s, 1978), The Art of Healthy Living — A Book for Women (Trca, 1980), The Encyclopedia of a Young Woman (Encyklopedie mladé ieny, 1978) and A School for Engaged and Married Couples (S’kola pro snoubence a novomanzele, 1977). The latter two are edited books, with articles on sexuality, family planning, motherhood and the domestic division of labour, which are written by doctors, psychologists, sex therapists and lawyers. The former two books were written by two doctors, Bardos’ and Trca. Tr6a also wrote the immensely popular antenatal guide We Are Going to Have a Baby (Tr6a, 1979), which is discussed in this chapter. He is also the author of the article on pregnancy in A School for Engaged and Married Couples, more or less repeating what he has said in his other writings. In addition, there are also free leaflets, distributed at antenatal clinics (when supplies permit), which cover nutrition, physical exercise and post-partum care, and which are for the most part written by the same authors who wrote these books.
These anecdotal, journalistic observations are not supported by the findings of Ispa (1983) who interviewed 30 Soviet women who recently (within the last 3 years) emigrated to the United States. They were all well-educated women of Jewish origin, from large cities, who had chosen to leave the USSR, and in this sense were ‘unrepresentative’ of Soviet women as such. The women interviewed reported that, at least in the large cities, there are prenatal classes and that they are attended during the eighth or ninth month of pregnancy. The classes focused on lectures on prenatal health, the physiology of birth, post-partum self-care, new-born care and the Communist Party’s concern for mothers and children. Exercises and breathing patterns are explained, but group practice sessions do not take place. Separate classes for men are apparently beginning to be available, but few attend.
It is worth noting that prenatal education in North America (started by the American Society for Psycho-prophylaxis in Obstetrics in 1959) stemmed from a radically different perspective: to raise women’s consciousness of her body and her ability to birth without the use of anaesthesia. It was meant to rock the system, not to comply with it. However, as we noted in Chapter 5, ASPO accepted the medical model’s separation of childbirth from the rest of the maternity experience and thus managed ‘to meet on the one hand the demand of women for a “natural” childbirth, and, on the other, the demand of obstetricians for “good medical management” ’ (Rothman, 1982, p. 92).
While Lumley’s and Astbury’s assessment seems persuasive, it is worth pointing out that they seem to be judging across the board, without indicating variations among countries, types of prenatal education, and findings on the impact of childbirth education on the childbirth experience. As we noted earlier, Glos (1978) found that non-attendance of prenatal classes had no negative impact on the length or the difficulty of the women’s labour while Vojta (1961a) found that psycho-prophylactic education resulted in shorter labour (its first stage was shortened by as much as 24 hours), less fatigue, lower reliance on analgesia throughout labour, faster post-natal recovery and more successful lactation. Oxorn and Foote (1975), authors of a widely used American medical textbook, also maintain that pre-natal education tends to lead to shorter and less traumatic labours, less medical intervention, less blood loss and less lack of oxygen to the baby. Kitzinger (1962) and Elkins (1980), renowned British and Canadian childbirth educators, respectively, are for obvious reasons also strongly in favour of antenatal education. As to ‘painless’ childbirth, initially (i.e. in the 1950s) Lamaze himself used the term. Currently no antenatal teacher manual, class, workshop or popular advice book mentions the absence of pain. Instruction in classes is geared towards reduction of unnecessary pain due to tension, and the acceptance of unavoidable pain through psychological techniques and breath-ing exercises (Maria Victor Paez, personal communication, Childbirth
and Parent Education Association of Toronto Teacher’s Handbook, 1979.)
While Wertz’s and Wertz’s comments are well taken, it is important not to look too romantically at the past. Bogdan’s (1978) and Macintyre’s (1977) accounts of childbirth practices in nineteenth-century America and primitive societies of the mythical golden age (in which childbirth was a purely ‘natural’ affair) suggest that the ‘human experience’ most people got out of viewing births first-hand was most likely harrowing. As Strong (1979, p. 205) has pointed out, ‘the plea of working women fifty years ago was for far more proper medicine to save them from the horrors that childbirth then entailed’. The movement for ‘natural’ child-birth only arose when medical advances had largely freed women from these fears. It is thus a product of ‘medical imperialism and entirely dependent upon it’.
In Poland, ‘the pregnant woman has a right to a paid release from work, if unable to do so after work, in order to go to a free medical examination if connected with said pregnancy. A medical direction to such an examination is the only basis necessary for the release from work.’ (Mieczkowsli, 1982, p. 53). While similar provision has been recently enacted in Britain, it appears to have no equivalent in the Soviet Union. Holland and McKevitt (1985, p. 154) speculate that ‘the loss of wages that results from attending clinics may well be a disincentive for some women’.
Author information
Authors and Affiliations
Copyright information
© 1987 Alena Heitlinger
About this chapter
Cite this chapter
Heitlinger, A. (1987). Pregnancy and Prenatal Care. In: Reproduction, Medicine and the Socialist State. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-07162-3_9
Download citation
DOI: https://doi.org/10.1007/978-1-349-07162-3_9
Publisher Name: Palgrave Macmillan, London
Print ISBN: 978-1-349-07164-7
Online ISBN: 978-1-349-07162-3
eBook Packages: Palgrave Social & Cultural Studies CollectionSocial Sciences (R0)