Medicalization of the Reproduction and Childbirth: a Struggle for Control

Abstract

This article aims to provide an analysis of the medicalization of childbirth. Medicalization is closely related to the biopolitical regulation of the population in terms of intensification of the influence which the medical profession and its expert knowledge is able to exert over people. In this paper I aim to show how the concept of medicalization and social control has developed and how, especially with the influence of feminist discourse, it has become one of the central concepts in the critical reflection and interpretation of reproductive health. Medical organisations and their accumulated knowledge provide expertise in reproductive practices, even though reproductive experiences of women vary in terms of their historical, geographical and social context. Attitudes towards the medicalization of childbirth and the need for controlled delivery differ for women differ for women depending both on their specific context and the social class they belong to. Certain women understand such control as an opportunity to actively influence aspects of childbirth, as the ability to participate in the decision-making process. Some of them feel that this process is manageable or under control; that they can receive certain support from the people (experts) who surround her, especially while she is in labour, and that they have all the necessary tools and information required.

Medicalization and medical control are integral components of the reproductive cycle and childbirth in modern Russia. However, it often appears that doctors do not possess a sufficient degree of expert power and professional autonomy, which in other contexts could allow them to impose their vision and control. This arises due to a lack of necessary resources on the part of doctors, their extreme dependence on the state, and the drastic bureaucratization of their responsibilities. Women are more interested in receiving quality obstetrics service and supervision (i.e. from respectable medical institutions and qualified specialists), then in restricting the control of the doctor and medical knowledge. The professional role of the midwife experiences is subject to alteration as women resorting to paid obstetric services can choose the their own path in childbirth. Doctors, midwives, and patients look for ways to adapt to bureaucratic formats through individual strategies and resources. These adaptation strategies have a real influence on the medicalization of reproduction in contemporary Russia.