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Childbirth, Midwifery and Concepts of Time

Childbirth, Midwifery and Concepts of Time

Edited by Christine McCourt
Copyright Date: 2010
Edition: 1
Published by: Berghahn Books
Pages: 272
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  • Book Info
    Childbirth, Midwifery and Concepts of Time
    Book Description:

    All cultures are concerned with the business of childbirth, so much so that it can never be described as a purely physiological or even psychological event. This volume draws together work from a range of anthropologists and midwives who have found anthropological approaches useful in their work. Using case studies from a variety of cultural settings, the writers explore the centrality of the way time is conceptualized, marked and measured to the ways of perceiving and managing childbirth: how women, midwives and other birth attendants are affected by issues of power and control, but also actively attempt to change established forms of thinking and practice. The stories are engaging as well as critical and invite the reader to think afresh about time, and about reproduction.

    eISBN: 978-0-85745-542-0
    Subjects: Anthropology, Public Health

Table of Contents

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  1. Foreword
    (pp. xiii-xviii)

    The introduction to this book reveals how ethnographers have, in their study of very diverse and scattered societies gone about showing the importance of time in the construction and analysis of childbirth behaviour and experience in different societies and groups across the world. My aim in this foreword, therefore, is to encourage readers to see this work in a more general and more theoretical context of how people involved in many diverse societies throughout history have successfully constructed and interpreted their reproductive experience and, especially, the extent to which different actors and genders in the process were sometimes in, but...

  2. Introduction
    (pp. 1-14)

    This book brings together and explores writings on the theme of time in relation to childbirth. The contributors include anthropologists, and midwives who have found anthropological approaches useful in their work. We aim to present a comparative approach, in order to gain wider insights from analysis of different cultural and organizational settings. Much of the work included in the book has taken place in so-called Western¹ or biomedical² settings, but nonetheless involves a comparative element by including a variety of cases and attempting to learn from the differences and similarities between them. As well as cross-cultural comparison, we look at...

  3. Part I Historical and Cultural Context

    • CHAPTER 1 From Tradition to Modernity: Time and Childbirth in Historical Perspective
      (pp. 17-36)
      Christine McCourt and Fiona Dykes

      This chapter traces key aspects of the historical shift from traditional to modern and then postmodern concepts of time. The two quotes with which it begins were chosen to illustrate how this shift emerged and is reflected in aspects of popular culture. Sterne’sTristram Shandyhas been regarded by many literary analysts as one of the first modern novels. The quote highlights the degree to which the plot and preoccupations of the story are centred on changes in notions of time of the author’s day, as well as changing notions of how childbirth should be managed. The associating childbirth with...

    • CHAPTER 2 Cosmologies, Concepts and Theories: Time and Childbirth in Cross-cultural Perspective
      (pp. 37-58)
      Christine McCourt

      The sociologist Adam (2004) has set out how religious philosophers through the ages have grappled with concepts of time. Time is present in origin myths – about the birth of humans in the world. She observed how successive world-views and modes of thought have understood time variously as universal and unchanging – a constant – and as ever changing, from past through present to future.

      The anthropologist Bloch (1989), meanwhile, has focused on basic anthropological questions about the universality or relativity of human thought and experience, asking whether human cultures are, at a basic level, universally the same while the detailed beliefs and...

  4. Part II Time and Childbirth Practices

    • CHAPTER 3 Counting Time in Pregnancy and Labour
      (pp. 61-83)
      Soo Downe and Fiona Dykes

      In this chapter we discuss some of the ways in which progress, duration and time are currently measured and monitored during pregnancy and labour. We recognize with many other writers in this area that the current approach to maternity care is located within the dominant paradigm of biomedicine and linearity. Our chapter uses a number of discourses, including feminism, consumerism, socio-economics and complexity theory. The critique we make of current authoritative approaches to time in the context of pregnancy and birth is based on a social constructivist interpretation (Boudourides 2003). The chapter commences with a brief summary of the concepts...

    • CHAPTER 4 The Progress of Labour: Orderly Chaos?
      (pp. 84-103)
      Clare Winter and Margie Duff

      This chapter continues the theme of ‘time’ in childbirth developed in Chapter 3 with a focus on labour and birth. It looks at the findings from two studies of midwives’ practices around assessment of progress in labour: one, a study of independent midwives’ practices in England (Winter 2002); and second, an Australian study where the authoritative model of childbirth is medical and the accepted place of birth is in hospital (Duff 2005). Both studies show how midwives working to an alternative model, which refers to traditions of midwifery but in a postmodern context, conceptualize and respond to the labour process,...

    • CHAPTER 5 Time and Midwifery Practice
      (pp. 104-125)
      Trudy Stevens

      The idea that the practice of midwifery is both an art and a science has long been promoted, as demonstrated by the title of a textbook written for advanced midwifery practitioners (Silverton 1993). However, in the above quote, Frankenberg has suggested that the practice of science and the art of healing involve radically different approaches defined by different notions of time, approaches so different as to be distinct and separate.

      In the arena of childbirth the distinction that Frankenberg drew between medicine and healing might readily reflect the ideological difference between obstetrics and midwifery; the one focuses on real or...

    • CHAPTER 6 ‘Waiting on Birth’: Management of Time and Place in a Birth Centre
      (pp. 126-144)
      Denis Walsh

      This chapter discusses temporality in relation to birth-centre care and forms part of the findings of an ethnography of a free-standing birth centre (FSBC) in the United Kingdom. The background to the study was the increasing interest in birth centres as a way of reducing interventions in childbirth. Intervention rates are escalating across the Western world with some U.K. studies showing that only a small minority of women experiencing their first birth do so without recourse to common medical interventions like syntocinon to speed up labour or operative delivery to terminate it (Downe, McCormick and Beech 2001; Mead 2008). A...

    • CHAPTER 7 Management of Time in Aboriginal and Northern Midwifery Settings
      (pp. 145-164)
      Gisela Becker

      This chapter explores Aboriginal concepts of time and their impact on maternity care for women and babies in a variety of midwifery settings in Canada. I describe the experiences of time management in a variety of Aboriginal cultures, including the Inuit in Nunavut and Nunavik (northern Québec), the Dene and Métis in the Northwest Territories, and the Six Nations in Ontario. Aboriginal concepts of time differ from non-Aboriginal concepts, where time is mainly seen as a linear concept. The Aboriginal concept of time may also vary, but in general terms situates events in a circular pattern of time, in which...

  5. Part III Time and Childbirth Experiences

    • CHAPTER 8 Narrative Time: Stories, Childbirth and Midwifery
      (pp. 167-183)
      Ólöf Ásta Ólafsdóttir and Mavis Kirkham

      Midwives and mothers have always told stories of births and their surrounding events and relationships. This chapter will explore the role of stories and storytelling in a piece of narrative research concerning childbirth and midwifery knowledge development. We will discuss themes from birth stories across time and space, mainly focusing on urban and rural Iceland and the U.K. This research is based upon work using ethnographic and narrative methodologies in relation to different aspects of midwives’ relationships with women (Kirkham 1997a, 2004). It is designed from a broad perspective, exploring the storytelling of Icelandic midwives’ in the period from the...

  6. CHAPTER 9 How Long Have I Got? Time in Labour: Themes from Women’s Birth Stories
    (pp. 184-201)
    Christine McCourt

    This chapter draws on women’s narrative accounts of their birth experience in a London hospital to look at the relationship between how time is managed in a modern maternity unit and how it is experienced by women in labour. These narrative interviews were conducted as part of a larger study evaluating attempted reforms in the U.K. towards a more ‘woman-centred’ maternity service.

    We discussed in Chapter 3 (this volume) the active management of labour in obstetrics, and how time is mapped out and managed in this system.¹ The partogram used in this approach gives a linear, graphical representation of time...

  7. Conclusion
    (pp. 247-252)

    The chapters in this book have looked at the theme of time and childbirth in various ways and from different perspectives. However, they all show ways in which methodological and theoretical approaches from anthropology can contribute to applied research on, in this case, maternity care and midwifery. The case studies presented in the chapters bring to life the very real concerns and dilemmas which link theory to practice. Here, we are literally touching on matters of life and death. Each has also touched to some degree on key debates within anthropology about the balance between universalism and relativism in social...