Narrating Birth: A Multiperspective Approach to the Retrospective Processing of the Boundary Experience of Childbirth
Keywords: childbirth, borderline experiences, narratives, medical culture, birth systems, knowledge systems, internet forums, communication
Childbirth as a borderline situation of human life, and a “bio-physio-social” (Villa/Moebius/Thiessen 2011) event is always accompanied by a set of culturally specific practices and bodies of knowledge. The analysis of the ways societies deal with giving birth and being born allows to draw conclusions regarding their characteristic relations of knowledge and cultural practice. One of these ways has been neglected in both scientific and humanistic research so far: Telling the story of (giving) birth. To fill this lacuna, the project approaches the narrative dimension of childbirth on a microlevel via the narration practices in a German Internet forum. Additionally the narratives of medical experts (physicians and midwives) are gained in narrative interviews and analyzed, in order to receive an impression of how both the biomedical master narrative and a holistic counter narrative influence the individual narratives of women who gave birth, and to give a snapshot of how birth is perceived by society in general.
Childbirth as a highly complex biological process always comes with a set of culturally specific practices in every society. Regardless of whether shamanic rituals or high technology medicine are applied: birth is seen as a harmful affair and all these practices help to cope with this borderline experience. Given this background of cultural diversity, the thesis characterizes the Central European “birth system” (Jordan 1980) from an anthropological point of view. It is shown that this particular system is characterized by modern, evidence based perinatal medicine and by an interest in maximum safety for mother and child. Obstetric experts hold the monopoly on knowledge about the physiological and pathological processes of childbirth – extensively offered and attended access to screening, constantly low mortality rates and a high number of hospital births illustrate the acceptance of this fact –, whereas popular, traditional or alternativemedical everyday knowledge are put into the background. This observation leads to the conclusion that there is a biomedical master narrative surrounding childbirth that does not perceive (a spontaneous, physiological) birth as a boundary experience at all, but rather as a routine medical intervention. This master narrative disregards that birth still is a “biosocial event” (Binder-Fritz 2003, 89) that mirrors the society's culture with all its values, moral standards, rules and regulations, and cannot be grasped as an exclusively biomedical phenomenon.
Nevertheless, the biomedical master narrative clearly shapes the perception of birth in the life world of pregnant women. Not only are there mandatory screenings and various medical practices surrounding pregnancy and birth, but also the necessity of knowing about these biomedical processes can be observed: Pregnancy without the consultation of medical advice literature (Baader 2008) or antenatal classes can hardly be imagined anymore. “The will to knowledge” (Foucault 1977) is strong. Everyday knowledge about birth and the exchange of individual experience seems to be neglected in the preparation of birth. In the aftermath, however, the individual experience clearly is in the focus.
To underpin this assumption the largest part of the dissertation deals with birth narratives. German-speaking Internet forums on maternal interests hold a great number of so called birth reports that are in fact elaborate narrations between orality and scripturality. This form of life writing is the empirical basis of the dissertation. 44 birth reports that were written in one forum over the course of one year are analyzed from a narratological point of view first (Bischoff/Oehme-Jüngling/Leimgruber 2014). It gets asked what different kinds of narratives are used in these virtual „narrative spaces“, which master and which counter narratives can be observed within the individual stories, and how telling stories can be seen as a part of coping with a borderline situation. Furthermore it gets asked how the existing birth-system is referred to on Internet forums. Is it accepeted without further questioning, is it challenged or defended? Is there any doubt or mistrust against expert knowledge (especially concerning biomedical developments), and how is it dealt with? First results show that the greatest part of the birth reports analyzed in this study describe childbirth as a borderline experience, some even talk of trauma, which opposes the biomedical master narrative.
The Internet as a communicative space has been on the agenda of the medical humanities for quite some time now (Früh 2000, Meyer 2009, Stegbauer 2005, concerning health: Eichenberg 2012). Its opportunities exert a visible influence on the relations between medical experts and laypeople, especially regarding the distribution of knowledge. Many people consult self help forums before they see a doctor, and discuss their diagnosis, fears or questions with others affected by the same disease. Especially the aspect of narrative seems to be important for these Online communities (Orgad 2005). The field of “childbirth narratives”, however, has not appeared on this research spectrum yet. This study aims to fill this lacuna.
In a second step, obstetrical experts (physicians and midwives) are confronted with the narratives from the forum, in order to start a narrative interview about how experts perceive childbirth. A first result can be seen in the physicians' lack of understanding for those birth reports that depict a – from a medical point of view – physiological delivery as a borderline or even traumatic event: the biomedical master narrative is based on the assumption that a physiological partus can not be a trauma, which eventually shapes the medical practice surrounding childbirth. Midwives, however, have their very own group narrative that opposes the biomedical master narrative. Their reaction to the reports is quite different and shows first and foremost that there is a conflict of competence between physicians and themselves. They see the birth narratives as a political symbol of the necessity of their profession within the birth system.
The thesis aims to theoretically capture the birth system of one 21st century western society from a narratological point of view. Its interest is not only on cultural anthropological insights but also on the practical relevance of its findings.
Author: Cecilia Colloseus
Cecilia Colloseus was invited to the University of Innsbruck to speak about her dissertation project. Her talk was recorded by the free radio station Freirad and broadcast as a feature with the title "Erzähl ma(ma)! Das Muttersein erzählen". The feature is now available as a podcast.
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