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Book part
Publication date: 25 November 2019

Zehra Zeynep Sadıkoğlu

Turkish mothers’ interactions with medical authorities during pregnancy and childbirth have developed in a context of risk discourses produced by biomedical experts with…

Abstract

Turkish mothers’ interactions with medical authorities during pregnancy and childbirth have developed in a context of risk discourses produced by biomedical experts with surveillance justified by these discourses. Giving meaning to pregnancy and childbirth through the search for the reduction of risks is a reflexive part of Turkish mothers’ everyday life.

This research paper aims to discuss a study examining how pregnancy and childbirth are socially constructed, how increased medicalization is experienced by Turkish mothers, and how they assign meaning to pregnancy and childbirth. A phenomenological research was designed using depth interviews with 10 Turkish mothers with children aged 0–6 years, living in Istanbul who had high education and welfare levels.

The findings shed light on Turkish mothers’ subjective experiences and how medicine as a profession shapes these experiences. With the medicalization of pregnancy and childbirth, how the trust toward the experts, the knowledge of preparation for maternity in an appropriate and responsible manner have become functional for Turkish mothers to create a sense of ontological security are examined.

Details

Childbearing and the Changing Nature of Parenthood: The Contexts, Actors, and Experiences of Having Children
Type: Book
ISBN: 978-1-83867-067-2

Keywords

Book part
Publication date: 28 March 2022

Stephanie N. Wilson

How is medical knowledge produced and what are the implications of that knowledge production for medical practice? Using theoretical ideas on evidence-based medicine…

Abstract

Purpose

How is medical knowledge produced and what are the implications of that knowledge production for medical practice? Using theoretical ideas on evidence-based medicine, standardization in medical research and practice, and biopower, I examine the relationship between medical knowledge and medical practice through the case of pelvic pain care in the US.

Methodology/Approach

Data from ethnographic observations at two medical conferences as well as interviews with healthcare providers inform a critical analysis of the medical discourse.

Findings

The analysis reveals how evidence-based medicine is practiced in the context of medical conditions that lack objective evidence, as well as the unintended consequences of such practices. I provide an alternative approach to medical practice for conditions lacking traditional evidence through presenting outlier cases in the data.

Research Limitations/Implications

In doing so, I make the broad theoretical argument that biomedical paradigms must emerge through the critical process of negative dialectics in order to reach past the limits of standardized medical care.

Originality/Value of Paper

In sociologically analyzing the case of pelvic pain care, I reveal dire limits in the evidence-based approach to medical care for conditions and symptoms that may be deemed medical anomalies, demanding an alternative approach to care for such conditions.

Details

Health and Health Care Inequities, Infectious Diseases and Social Factors
Type: Book
ISBN: 978-1-80117-940-9

Keywords

Book part
Publication date: 21 October 2008

Adina Nack

Medical encounters are interactional/interpersonal processes taking place within contexts shaped by macro-level social structures. In the case of sexually transmitted diseases…

Abstract

Medical encounters are interactional/interpersonal processes taking place within contexts shaped by macro-level social structures. In the case of sexually transmitted diseases (STDs), medical encounters occur at a stigmatized crossroads of social control and gendered norms of sexual behavior. When women are diagnosed and treated for chronic STDs, practitioner demeanor has an important impact on how patients will view not only their health status but also their moral status. This chapter draws on in depth interviews with 40 women diagnosed with genital infections of herpes and/or human papillomavirus (HPV – the cause of genital warts) to explore three models of patient–practitioner interaction. The analysis focuses on the relationship between gender, construction of illness, and practitioner interaction style. In a broader context, the health risks posed by particular interaction styles to female STD patients shed light on larger public health implications of combining morality with medicine for the broader range of patients with stigmatizing diagnoses.

Details

Care for Major Health Problems and Population Health Concerns: Impacts on Patients, Providers and Policy
Type: Book
ISBN: 978-1-84855-160-2

Book part
Publication date: 22 November 2019

Siri Suh

To explore the politics of gender, health, medicine, and citizenship in high-income countries, medical sociologists have focused primarily on the practice of legal abortion. In…

Abstract

To explore the politics of gender, health, medicine, and citizenship in high-income countries, medical sociologists have focused primarily on the practice of legal abortion. In middle- and low-income countries with restrictive abortion laws, however, medical sociologists must examine what happens when women have already experienced spontaneous or induced abortion. Post-abortion care (PAC), a global reproductive health intervention that treats complications of abortion and has been implemented in nearly 50 countries worldwide, offers important theoretical insights into transnational politics of abortion and reproduction in countries with restrictive abortion laws. In this chapter, I draw on my ethnography of Senegal’s PAC program to examine the professional, clinical, and technological politics and practices of obstetric care for abortions that have already occurred. I use the sociological concepts of professional boundary work and boundary objects to demonstrate how Senegalese health professionals have established the political and clinical legitimacy of PAC. I demonstrate the professional precariousness of practicing PAC for physicians, midwives, and nurses. I show how the dual capacity of PAC technologies to terminate pregnancy and treat abortion complications has limited their circulation within the health system, thereby reducing quality of care. Given the contradictory and complex global landscape of twenty-first-century abortion governance, in which pharmaceutical forms of abortion such as Misoprostol are increasingly available in developing countries, and as abortion restrictions are increasingly enforced across the developed world, PAC offers important theoretical opportunities to advance medical sociology research on abortion politics and practices in the global North and South.

Book part
Publication date: 30 June 2004

Carol A.B Warren

The medical suppression of female sexuality in Victorian society has long been the subject of historical and cultural scholarship, with documentation not only of textual threats…

Abstract

The medical suppression of female sexuality in Victorian society has long been the subject of historical and cultural scholarship, with documentation not only of textual threats by religious and medical “experts,” but also of surgical assaults on female reproductive systems (Longo, 1979, 1986; Scull & Favreau, 1986; Sheehan, 1997). Less well known is the apparent obverse: the use of medical techniques to stimulate the female genitalia as a means of treating hysteria and other mental disorders (Maines, 1999; Schleiner, 1995). In this paper, I trace the cultural history (mainly Anglo-American) of the psychiatric enhancement, as well as repression, of female sexual pleasure, through various genital treatments, including the surgical and the electrical.1 I then make the case that these “opposite” treatments are, in the context of Victorian society, two sides of the same coin of the patriarchal, medical control of female sexuality.2

Details

Gendered Perspectives on Reproduction and Sexuality
Type: Book
ISBN: 978-0-76231-088-3

Book part
Publication date: 25 July 2015

Francesca Minerva

Healthcare practitioners, according to legislations in most Western countries, may refuse to perform some medical activities that conflict with their moral and religious values…

Abstract

Healthcare practitioners, according to legislations in most Western countries, may refuse to perform some medical activities that conflict with their moral and religious values. The Roman Catholic Church has declared in official documents that doctors should not perform or facilitate activities considered immoral such as abortion and euthanasia. The goal of this paper is to suggest new options for regulating conscientious objection of Roman Catholic healthcare practitioners.

Details

Conscience, Leadership and the Problem of ‘Dirty Hands’
Type: Book
ISBN: 978-1-78560-203-0

Keywords

Book part
Publication date: 20 October 2014

Lauren Nicholas

Twin to Twin Transfusion Syndrome (TTTS) is a well understood, yet under-recognized, placental disease affecting any given pregnancy at a rate of 1 in 1,000. There is no…

Abstract

Purpose

Twin to Twin Transfusion Syndrome (TTTS) is a well understood, yet under-recognized, placental disease affecting any given pregnancy at a rate of 1 in 1,000. There is no clustering of TTTS; instead the threat remains pathologically distinctive due to its pervasiveness. However, while incidence rates are random, survival rates are not. Despite compliant acceptance of “routine prenatal care,” sadly, there are many women who for currently unknown reasons are not receiving the advanced prenatal care needed to appropriately screen for, diagnosis and treat TTTS. And these women are paying the ultimate price for such obstetrical oversight.

Methodology

This study hypothesizes that differential care being given by primary obstetricians of TTTS patients is resulting in experienced inequalities. Utilizing social reproduction theory, and through ethnographic and quantitative analyses of primary data, this study seeks to divulge the complex social processes taking place (or failing to take place) within the world of American obstetrics, and begin to understand how they are affecting TTTS mortality and morbidity rates.

Findings

Findings illuminate a profound imbalance of power and influence amongst the following entities: American Congress of Obstetricians and Gynecologists and Society of Maternal Fetal Medicine; obstetrical training and practice; and levels of patient awareness and advocacy.

Value

This study argues that the current social relations being reproduced by these entities are perpetuating a climate that allows for disregard of proper TTTS management. Specifically, this study theoretically explores what social relations and subsequent (in)actions are being reproduced prior to TTTS diagnoses, and applies the effects of those observations.

Details

Family and Health: Evolving Needs, Responsibilities, and Experiences
Type: Book
ISBN: 978-1-78441-126-8

Keywords

Book part
Publication date: 22 November 2019

Kellie Owens

As maternal mortality increases in the United States, birth providers and policymakers are seeking new solutions to address what scholars have called the “C-section epidemic.”…

Abstract

As maternal mortality increases in the United States, birth providers and policymakers are seeking new solutions to address what scholars have called the “C-section epidemic.” Hospital cesarean rates vary tremendously, from 7 to 70 percent of all births. Based on in-depth, semi-structured interviews with 47 obstetricians and family physicians in the United States, I explore one reason for this variation: differences in how physicians perceive and manage risk in American obstetrics. While the dominant model of risk management encourages high levels of intervention and monitoring, I argue that a significant portion of physicians are concerned about high intervention rates in childbirth and are working to reduce cesarean rates and/or the use of monitoring technologies like continuous fetal heart rate monitors. Unlike prior theories of biomedicalization, which suggest that health risks are managed through increased monitoring and intervention, I find that many physicians are resisting this model of risk management by ordering fewer interventions and collecting less information about their patients. These providers acknowledge that interventions designed to mitigate risks may only provide an illusion of control, rather than an actual mastery of risks. By limiting interventions, providers may lose this illusion of control but also mitigate the iatrogenic effects of intervention and continuous monitoring. This alternative approach to risk management is growing in many medical fields and deserves more attention from medical sociologists.

Details

Reproduction, Health, and Medicine
Type: Book
ISBN: 978-1-78756-172-4

Keywords

Book part
Publication date: 12 August 2009

Elke Weik

This chapter at hand applies and extends Friedland and Alford's model of institutional logics to the case of birth practises focusing on a number of interrelated topics, namely…

Abstract

This chapter at hand applies and extends Friedland and Alford's model of institutional logics to the case of birth practises focusing on a number of interrelated topics, namely, identity, trust, and ideology. It draws on Giddens's theory of modernity to “bring society back in,” as Friedland and Alford have formulated one major point of critique against existing institutional approaches. In its theoretical discussion, the chapter will focus on two issues: first, the treatment of conflict as a motor of institutional dynamics, and second, the relation between institutions and agency. The empirical data is based on participant observation, qualitative interviews with midwives and obstetricians, and a review of magazines and television material concerning birth and parenting.

Details

Institutions and Ideology
Type: Book
ISBN: 978-1-84855-867-0

Book part
Publication date: 1 January 2008

Gayle A. Sulik and Astrid Eich-Krohm

Purpose – This chapter examines medical consumerism and the changing relations between patients as consumers and the medical system across two women's health contexts, breast…

Abstract

Purpose – This chapter examines medical consumerism and the changing relations between patients as consumers and the medical system across two women's health contexts, breast cancer and infertility.

Methodology/approach – The analysis draws on two qualitative studies: The first explores the experiences of 60 breast cancer survivors through in-depth interviews and participant observation (Sulik, 2005), and the second uses in-depth interviews to analyze 18 women's experiences with infertility (Eich-Krohm, 2000).

Findings – The medical consumer is an individualized role that shifts attention away from the quality problem in health care and toward the quality of the person as a medical consumer who is characterized to be optimistic, proactive, rational, responsible, and informed.

Research limitations/implications – As medicine has become a form of mass consumption, the category of medical consumer has elevated the individual in medical decision-making. The shift from patient to medical consumer is an ongoing process that is grounded in a tension between medical control and individual agency, and is exacerbated by the intensity and incomprehensibility of modern medicine.

Practical implications – The proliferation of medical information and personal illness narratives through the Internet, advice books, and self-help groups have advanced lay knowledge about preventive medicine and medical treatment while simultaneously introducing new fears and anxiety about the multitude of options and outcomes.

Originality/value of chapter – This study contributes to our knowledge on medical consumerism and its impact on illness experience and the synthesis of lay and professional knowledge.

Details

Patients, Consumers and Civil Society
Type: Book
ISBN: 978-1-84855-215-9

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