Author:Maud Arnal ( EHESS/ McGill )
Paper short abstract:
This paper investigates the alternative modes of power and the legitimization of expertise of the relief pain in obstetric. How does the standardization of epidural anesthesia in obstetric brings to reconsider the boundaries between what belongs to « nature » and what comes out?
Paper long abstract:
What does the pain of childbirth mean to you? Would you wish to feel the pain? Your mental health might be clinically suspected if you answered 1) « pleasure », 2) « yes! ». Between dangerousness, "culturally patterned", biological determinism and empowerment of women, the relief of labor pain is today a question a priori set by the development of anesthesia techniques. Drug treatment of pain during childbirth, circumscribed around epidural anesthesia, became widespread, to the rank of dominant health standard in developed countries. For its social and subjective implications, childbirth and its pain are still located in a medical and social paradigm in which are confronted the categorization of this pain. For some medical professions, this archaic pain is to be treated. For some feminists, it comes to treating the appropriation of women's bodies by epidural by abolishing the massive use of this technique (Duden, 1993). If no one wants to suffer during childbirth, how do alternative practices to pharmacological technical produce a bunch of « tacit knowledge » that come to question the scientific basis on acquired understanding of pain relief of women during childbirth? This comparative research is based on seventy-five semi-directed interviews (with health professionals and users) and non-participant observations conducted in the public hospitals and in birth houses in Quebec and France. This paper aims to examine the circumvention strategies of dominant standards to understand how is structured an intuitive and clinical knowledge field from the body of women in the development of medical scientific knowledge (Scheper-Hughes and Lock, 1987).
By whose authority: investigating alternative modes of power and the legitimization of expertise