Medical Childbirth Made in the Czech Republic: Required and Desired Practices
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| Year of publication | 2013 |
| Type | Appeared in Conference without Proceedings |
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| Description | The paper thematizes polarisation in a debate on the quality of Czech reproductive medicine in the area of childbirth: Is medicalized or "natural" childbirth the desired and/or required practice? It concentrates mostly on and presents the points of view of medical doctors in the specialisation of gynaecology and obstetrics. In the Czech context, in contrast to many other European countries, medical doctors are the professionals legally and normatively responsible for and present at every childbirth. And they are advocating for the status quo. The goal of the presentation is to understand and explain their standpoints, frame them in broader social contexts, and facilitate relevant arguments for the public as well as expert discussions on changes in Czech obstetrics from a sociological point of view. Czech medical care is reaching top ranks in indicators concerning low mortality and morbidity figures at "delivery" in international standards. Basically all births take place in hospitals (no legal alternatives) and are led by medical doctors. (All is covered by the state governed system of health care and compulsory insurance.) At the same time, strong voices confronting this favourable evaluation and medicalized practice are heard from the civic society initiatives representing a significant segment of birthing women and independent midwifes, pointing out the limits of wellbeing of women and their dissatisfaction with the birthing process following hospital routine procedures. They also stress that the Czech Republic does not follow particular international standards concerning the "baby friendly", "patient choice" and "natural" childbirth approaches, and that the practice is strongly biomedicalized. The ideological clash is strongly polarized; standpoints of representatives from the polar groups are fiercely criticized reciprocally. Few attempts for a moderated cooperation have resulted in a failure, so far, "the common language has not been found". The powerful party is, based on significant structural context, the biomedical one. I have conducted interviews with medical doctors with long experience in maternity wards in hospitals, and offer their points of view, opinions on desired changes in the area of "childbirth" – "delivery", as well as an interpretation frame for their arguments based on their everyday experience of legal responsibility for the outcome of the event, and their working lives within the system of the Czech healthcare. Concepts of authoritative knowledge, biopolitics, and governmentality as well gender hegemonies have been incorporated in the analysis to help sociologically grasp the phenomenon of "desired and required childbirth". |
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