WUNRN
Women’s
Decisions on Where to Give Birth – Variables for Safe Motherhood
22 Sep 2015 - The traditional medical view of risks associated with giving
birth sometimes clashes with what women themselves perceive.
In the Netherlands, some women go against medical advice in choosing
homebirths, because they consider the biomedical model of birth as being risky.
They see it as a model in which they have less autonomy and free choice (and in
which more intervention during labour is required). In this case, home is seen
as a safer haven than the health system. (Study by Lianne Holten from VU
University Amsterdam)
While actors in the health system are only required to consider the risks
associated with the delivery itself, in Malawi, women are faced with a number
of complications to consider and manage when deciding whether to give birth at
home or at a hospital (e.g. family responsibilities, distance to facility,
etc.). In order to improve safer motherhood messages it is important to
understand how the women themselves perceive risk. (Research by Isabelle Uny -
Queen Margaret University)
Similarly, women in Rwanda have multiple concepts of risk in pregnancy and use
both biomedical and traditional methods to address these risks. Again, the
government needs to keep these are considerations in mind. Rwanda may have
reduced maternal mortality rates by two thirds in 10 years through strong
government policies, but the way in which these have been delivered is
sometimes seen as being disempowering and counterproductive. (Research by
Frances Haste)
In Manitoba, a remote community in Canada, pregnant women are evacuated to a
larger city in order to give birth at 37 weeks. These women and their home
environments are constructed as high risk by the government, which can be
considered a very technocratic view of birth. The women face a number of
non-medical issues during their stay in this town (e.g. isolation, etc.) which
also need to be taken into account. (Study by Rachel Olson -The Firelight
Group).
These cases show that reproductive health is conceptualised differently in
household decision-making and in the health policy discourse. They were
presented as part of a panel on ‘Maternal precarity is at the intersection of households
and health systems’ at the MAGic2015 conference on ‘Anthropology and
Global Health: interrogating theory, policy and practice’ . This conference
took place at the University of Sussex from 9-11th September 2015 and aimed to
interrogate the paradigms and practice of global health.
A myriad of topics were discussed at the conference. One of the key topics for
discussion was the ebola epidemic. The conference started with a plenary
session on the topic and included various panels stressing the importance of a
community-based and community-led Ebola response. Other topics discussed
include: chronicity and urbanisation, health and policy.