The Politics of Birth
With her 50 years as a policy entrepreneur in the politics of birth, Sheila Kitzinger is an institution. In this compact book she brings together her wisdom and vision on the current technocratic model of birth and potential avenues for change. She explores core features of birth cultures and birth systems, bridging the powers of creative social anthropological / sociological analysis with her detailed knowledge and understanding of birth practices. She not only sheds light on the mainstream, but also on birth care for women in the margins of society, such as prisoners or asylum seekers. She employs a poetic, powerful language, calling attention to the language of rape women use to describe their experiences of giving birth. She further criticises obstetrics for its continued use of disempowering language of birth that encourages women to give control over birth to doctors. Birth cannot and should not be controlled according to Kitzinger. Birth is movement, she argues, and invites us to rediscover the 'birth dance', that is, women's instinctive knowledge on giving birth that involves knowing when to push as easily as knowing how to swallow. She asserts that a woman giving birth should be accompanied by an alert midwife, who is learned in the science of keeping birth normal. She proposes a redefinition of midwives as professionals free to become 'better carers, and more effective researchers, activists and advocates for the woman.'
In my reading, Kitzinger's discussion of the alienating, dehumanizing systems of birth that have taken shape in most Western countries, and more recently all over the world, powerfully resonates with the poststructuralist analysis of gendering as something involving the distribution of pain and embodiment (Fournier, 2002). From this perspective, the idea of gender is made real through material acts, i.e., 'the wounding of women's bodies'. Thus, by stopping women moving at birth, modern obstetrics puts in motion a never ending, violent chain of interventions, as Kitzinger demonstrates. This exercise of medical power reduces a woman giving birth to an uncontrollable body.
Kitzinger offers ways to break out from the technocratic prison that encages birth. The powerful vision of birth dance and her nuanced and insightful discussions of the positions of women at society's margins provide a multilayered analysis of both birth culture and birth system, thus lifting the issue of birth from its technocratic frame into the frame of birth as an issue of equality, human rights and ethical practice. The only problem I have with her analysis is that the main responsibility for change is given to midwives. In my mind too little responsibility is given to the women themselves and particularly to those here merely identified as the 'others' of health policy. To midwives this is surely the task of Sisyphus, to be doomed to ceaselessly rolling a rock to the top of a mountain. Instead, the agency of ordinary women needs to be afforded focal attention. It seems to me that many of them no longer accept being clients in need of advocacy and claim the right to be actors in their own right, treating would-be advocates with suspicion. At the same time, in an age when delivery trends are becoming increasingly consumerist and commercial, birthing women really need the kind of visionary books on birth that Sheila Kitzinger provides.
ReferenceFOURNIER, V. (2002) Fleshing out Gender: Crafting Gender Identity on Women's Bodies. Body & Society 8(2): 55-77.
University of Helsinki