CC BY
6Despite the volatility of this context, some forms of communication between key participants remain stable and have been in place since the Soviet period. In particular, the "Soviet approach" was recognized as paternalistic (Rivkin-Fish 2005). That is, assuming an asymmetry of power between patients and medical professionals, between the latter and the management of healthcare organization, and between entire health care system and the state ideology (Field 1957; Saks 2015). Thus, social and healthcare reforms carried out since the early 1990s have shaped the context of healthcare institutions in Russia, but the latter remains largely "unfriendly" to patients and reproduces inequality at the level of social structures and everyday communications. This study, based on qualitative semi-structured interviews with health practitioners and patients, as well as on a series of observations in a medical center, addresses the sustainability of the rude and unfriendly forms of. In addition, the study describes some forms of undesirable communication between patients and healthcare practitioners, or between representatives of different professional groups.
Keywords: maternity care, healthcare professionals and organizations, communication in medicine, emotional styles, khamstvo
DOI:
PREPARATION FOR CHILDBIRTH IN THE CONTEXT OF INTENSIVE MOTHERHOOD: BASIC FUNCTIONS
AND PARADIGMS
Anna Ozhiganova
Senior Researcher, Center of Medical Anthropology, Institute of Ethnology and Anthropology of the Russian Academy of Sciences, Moscow, Russia; e-mail: anna-ozhiganova@yandex.ru
Abstract: The practice of teaching pregnant women using specialized courses is becoming increasingly popular due to the widespread ideology of intensive or conscious parenting since the end of the XX century. This training serves many functions e.g., obtaining information, physical training, gender socialization, communication, psychological training, and even the experience of altered states of consciousness. The concept of authoritative knowledge about pregnancy and childbirth proposed by the American anthropologist B. Jordan (1993), analyses the knowledge that is produced and transmitted in preparation for childbirth and characterizes it as a kind of synthesis of the (bio) medical and the alternative. This includes the experienced knowledge of individual (homebirth) midwives. This approach also draws attention to the distribution of authority knowledge depending on the type of relationship between participants - horizontal or hierarchical. This study is based on field materials including interviews with women and trainers, as well as participant observation data from birthing preparation centers and the results of a small online survey conducted in March-April 2022. Different approaches presented in Russian parenting centers are examined and a conclusion is made that there are several basic styles or paradigms of preparation for childbirth, which can be conventionally assigned as radical, neoliberal, traditionalist, and reflexive. The radical version of preparation, which dates back to the ideological paradigm developed among alternative parents in the 1980s and 1990s, uses the rhetoric of a woman's personal responsibility for the outcome of childbirth and does not view pregnant women as patients. The neoliberal paradigm, closely linked to the ideology of intensive motherhood, focuses primarily on the expert knowledge of physicians, but also on the knowledge of professional midwives and birthing leaders. The traditionalist approach appeals to patriarchal family values and gender roles and seeks to recreate an extended family atmosphere and benevolent communication in a "women's circle". The reflexive approach favors psychological and meditative practices; preparation for childbirth is positioned as a creative project of the woman herself, in which she invests important meanings for herself.
Keywords: preparation for childbirth, intensive parenting, authoritative knowledge about pregnancy and childbirth, medicalization of childbirth, responsibility
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