Abstract
This chapter presents the setting both physically and culturally. We take a critical position on the role of the institution, drawing on the theory of critical medical anthropology (CMA) and Foucault’s conceptions of panoptic surveillance and the medical gaze. Using the field note data and centring on two disparate notions—organisational and midwifery technologies—institutional influence on time, organisation of labour and birth, risk and safety, and midwifery practice are discussed. An inherent contradiction within the institution is revealed.
JADE
Round about 1 o’clock I could feel I was getting contractions,
Which I didn’t get really the last time;
I was induced.
So I kind of had a feeling
But I wasn’t sure,
So I went to the bathroom and just
Sat in the bath for a while.
They came really quick,
Really hard,
My partner was running around going crazy a bit,
He was trying to pack my hospital bag—
I still hadn’t gotten around to it.
It was only about an hour and half til I went to the hospital because
They were about 5 minutes apart
Pretty much straight away.
Yeah I went to the hospital
And then I pretty much asked for the pain relief straight away.
I was very insistent that I got the gas straight away.
I had a heat pack this time around which was lovely
That helped so much compared to just the gas.
I think it was a lot more relaxed because
I only had two people in there.
I think it was so late and they were so busy they could only have one or two people there.
And because it wasn’t planned it just made it a lot calmer.
Because I only had two people pretty much in there the whole time,
Which was really nice.
Because the last time
I had interns coming in every 5 minutes,
Or just random people coming in and talking.
And the last time getting the epidural took about 6 or 7 hours
Whereas this time they organised it straight away
So that was really nice.
Until the epidural failed twice
And then I ended up just basically doing it natural at the end.
The epidural fail was horrible.
But in a way I am kind of glad it did because
I was able to feel the urge to push.
I didn’t feel that last time.
I had to be told when to push
This time I was like ‘Yeah I need to push now, get it out!’
And then the pushing only took 7 minutes.
I wasn’t sitting there pushing for an hour because I couldn’t feel when I had to.
I actually felt her come out!
I didn’t feel that with my son.
It was good, it was good,
But the whole epidural thing wasn’t good.
It was just different
Because I could actually feel that I was giving birth
I could actually feel my body doing something
that it was meant to do.
I could feel—
and I knew it would result in her
I don’t know,
I think it was just better,
I don’t really know how to explain it.
Yeah I think because I have had one where I didn’t feel anything,
Then a second way, which was positive, because I could feel her
If I could just cut out the contractions, that would be lovely
I wouldn’t mind feeling giving birth.
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Notes
- 1.
There are various names for the place in which women give birth in a hospital. The old terminology of ‘labour ward’ has in many places been replaced with ‘birth suite’ or other such terminology. In recent studies from the United Kingdom, the current terminology appears fairly consistent, with obstetric unit (or OU) used for hospital labour wards and midwifery unit (MU) for birth centres, or midwife-led units (these can then be prefixed to give context: alongside midwifery unit [AMU], free-standing midwifery unit [FMU]). We decided in this study to stick with the terminology of ‘labour ward’ because it felt more anonymous to describe it in ‘old’ terminology and because this term also felt quite accurate in the way it seems to invoke ‘the institution’.
- 2.
Note from EN: I was surprised when I noticed my use of the word ‘patient’ here. I had not consciously used this term, and as a fervent believer in the importance of language, would not normally use it in a midwifery context.
- 3.
This was coined from a health insurance company television commercial advertising their coverage of ‘alternative’ medicine. While in the hospital it was used as more tongue-in-cheek than outright derogatory, its use highlights the ridiculing of ‘traditional’ or ‘alternative’ practices.
- 4.
We agree that relief from unbearable pain in labour can give women a sense of wellbeing and control, but this does not mean that other states, such as feeling empowered or involved in her experience should be belittled.
- 5.
Shown in the following analytic memo:
Are midwives responsible for ‘getting babies out’? Do obstetricians rely on midwives for keeping the normal going? If they do, what does this mean? Does this mean that it is midwives who are perpetuating the medicalisation…not always as I have seen them directly oppose obstetric opinion (Field notes 31/5/12).
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Newnham, E., McKellar, L., Pincombe, J. (2018). Institutional Culture: Discipline and Resistance. In: Towards the Humanisation of Birth. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-69962-2_4
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