Paper short abstract

Illegal medical practices are controversial: they can combine both progressive and outdated approaches, contribute to the humanization of care and lead to tragic incidents. An anthropologist working in this field has to make a contradictory combination of interested study and militant research.

Paper long abstract

Post-Soviet Russian healthcare is characterized by a high level of institutional distrust, bureaucratic pressure of the State, and the vulnerability of doctors who do not have sufficient professional autonomy. In this situation, positive changes in healthcare in general and maternity care in particular often come from informal practices and relationships. As a medical anthropologist, I find myself in an ambiguous position as I need to maintain trust relations with different actors: obstetricians-gynecologists and hospital chiefs, professional midwives and homebirth midwives, doulas, and childbearing women. All interlocutors appeal to various authoritative sources and have their versions of knowledge about pregnancy and childbirth, which contradict each other. The situation is complicated by different informal practices, which may include childbirth with a doula, hiring homebirth midwives to work at the hospital, and even organizing a space for natural childbirth, which are often associated with violations of bureaucratic rules and protocols. Illegal medical practices (such as homebirth) are also very controversial: they can combine both progressive and outdated approaches, contribute to the humanization of care and lead to tragic incidents. I face many ethical challenges doing research in this contradictory field: I get potentially dangerous information and could be considered as an accomplice; I cannot publish the full information, and complete anonymization of data impoverishes the content. The inability to fully accept the position of one of the parties leads to the fact that I have to make a contradictory combination of interested study and militant research.