Paper long abstract:

This paper looks at childbirth within the medical pluralistic context of a Moroccan oasis, where the local knowledge of birth is a contested domain. Central in the social reproduction of the community, it is perceived as endangered by the lack of its transmission and by the attempts of eradicating the role of 'traditional birth attendants' ('TBAs'). National policies actually strive for the medicalisation of birth and forbid their training. Some local birth attendants incorporate instead local and biomedical knowledge of birth eclectically. Flexibility, pluralism and pragmatism come significantly into play also in mothers' approaches to childbirth, especially in facing complications during labour and in balancing between the risks of home birth and those of long-distance transfer to hospital. This paper argues, therefore, that birth practices, understandings of risk, the access to prenatal care and maternal mortality are as much socio-cultural as historical products, to be contextualized in the broader political economy of health.