Volume 24, Issue 92 (5-2024)
refahj 2024, 24(92): 79-116 |
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Zahabi E, Naficy N, Ahmadnia S. (2024). Pregnancy and Inequality: Embryo to Newborn in the Womb of Health System. refahj. 24(92), : 3 doi:10.32598/refahj.24.92.4328.1
URL: http://refahj.uswr.ac.ir/article-1-4194-en.html
URL: http://refahj.uswr.ac.ir/article-1-4194-en.html
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Introduction
The present article is the result of a one-year field research on the experiences of pregnancy and childbirth in the upper and lower Tehran (referring to socioeconomic status) medical centers in 2020s.
Since the beginning of the 20th century, pregnancy and childbirth in most parts of the world have been medicalized (Kukla et al, 2018: 2). The medicalization of childbirth does not only mean direct medical intervention in pregnancy and childbirth; rather, it refers to a culture that, both inside and outside of health centers, makes pregnancy a medical issue that requires crisis and risk management.
Iran, like many other countries, has been in the process of medicalization and commercialization of pregnancy and childbirth in recent decades.
This research has studied a part of bio-politics mechanisms of pregnancy and childbirth in Tehran using ethnographic method. The important point in this research is how the experience of pregnancy from conception to infancy is unevenly shaped in the mechanisms of the health system, and how these women with different economic, social and cultural capitals act and express themselves.
Method
In this research, multi-field ethnographic method has been used. The fields include two public and private hospitals, several health centers, two midwifery offices in the south and east of Tehran, as well as virtual space, especially various pregnancy applications and WhatsApp groups. In addition, twelve individual interviews and seven group interviews were conducted. Two hospitals were continuously visited by the researcher more than other centers for around six months, three to four days a week from morning to the evening.
The ethnographer observed people in therapeutic environments and participated in their daily activities as much as possible, the methods that have been used to collect data in this type of study are unstructured, flexible, and unlimited, and include participatory observation, in-depth interviews, and natural language discourse analysis.
Findings
Part of the research findings presented in this article is focused on the culture that governs the hospital and the existing hierarchy, the role and place of pregnant women in this space, and the knowledge they gain about the status of the economic class. A definition of health and a picture of the socialization of babies before entering this world is also presented. Some main findings are as follows:
Discussion:
Different dimensions of discrimination in different forms and sectors show that inequality in the field of location, language, body, services, and the quality of delivery condition all show that women and fetuses in their wombs have different experiences in the pregnancy process.
Findings show that hospital is not like an isolated island, but it is a part of a mainland. Some believe that the uniforms and the condition of the hospitalized patients makes the hospital a place that hides the existing class structure for the duration of treatment. It was shown that the social hierarchy extends in the hospitals and the life in the hospital is the continuation of the same structure that flows outside.
The pregnant body also is exposed to judgments in the process of childbirth. Humiliation, and shame is a class distribution and lower-class women face this more frequently.
The condition of the body changes based on the location and type of public or private services. In fact, private and public affairs each impose special conditions on the pregnant woman's body.
We also followed the course of emotional evolution of hospitalized pregnant women in public sector, and we argued how this path leads to an evolution in class consciousness.
The health standards can be defined based on class characteristics. Social class has an important effect on people's beliefs and attitudes towards health. The type of exposure to the delivery method, abortion treatment and disability are all different based on the social class.
And finally, in the current mechanism of human production in Tehran, choices for parents are far different from each other and consequently for their babies, both before and after birth; however, it is not only in private sphere, rather in a public and political arena between those who are expected to play an active role in building a nation and those who do not.
Ethics:
This essay is on a code of ethics; and assumed names have been assigned to maintain the anonymity of participants. The health centers are also confidential.
The present article is the result of a one-year field research on the experiences of pregnancy and childbirth in the upper and lower Tehran (referring to socioeconomic status) medical centers in 2020s.
Since the beginning of the 20th century, pregnancy and childbirth in most parts of the world have been medicalized (Kukla et al, 2018: 2). The medicalization of childbirth does not only mean direct medical intervention in pregnancy and childbirth; rather, it refers to a culture that, both inside and outside of health centers, makes pregnancy a medical issue that requires crisis and risk management.
Iran, like many other countries, has been in the process of medicalization and commercialization of pregnancy and childbirth in recent decades.
This research has studied a part of bio-politics mechanisms of pregnancy and childbirth in Tehran using ethnographic method. The important point in this research is how the experience of pregnancy from conception to infancy is unevenly shaped in the mechanisms of the health system, and how these women with different economic, social and cultural capitals act and express themselves.
Method
In this research, multi-field ethnographic method has been used. The fields include two public and private hospitals, several health centers, two midwifery offices in the south and east of Tehran, as well as virtual space, especially various pregnancy applications and WhatsApp groups. In addition, twelve individual interviews and seven group interviews were conducted. Two hospitals were continuously visited by the researcher more than other centers for around six months, three to four days a week from morning to the evening.
The ethnographer observed people in therapeutic environments and participated in their daily activities as much as possible, the methods that have been used to collect data in this type of study are unstructured, flexible, and unlimited, and include participatory observation, in-depth interviews, and natural language discourse analysis.
Findings
Part of the research findings presented in this article is focused on the culture that governs the hospital and the existing hierarchy, the role and place of pregnant women in this space, and the knowledge they gain about the status of the economic class. A definition of health and a picture of the socialization of babies before entering this world is also presented. Some main findings are as follows:
- Hospital: A separated island or part of the mainland:
- Conscious choice or passive determinism:
- Public and private spaces:
- Healthy fetus in social classes:
- Luxury babies Vs. Canal-sleeping babies:
Discussion:
Different dimensions of discrimination in different forms and sectors show that inequality in the field of location, language, body, services, and the quality of delivery condition all show that women and fetuses in their wombs have different experiences in the pregnancy process.
Findings show that hospital is not like an isolated island, but it is a part of a mainland. Some believe that the uniforms and the condition of the hospitalized patients makes the hospital a place that hides the existing class structure for the duration of treatment. It was shown that the social hierarchy extends in the hospitals and the life in the hospital is the continuation of the same structure that flows outside.
The pregnant body also is exposed to judgments in the process of childbirth. Humiliation, and shame is a class distribution and lower-class women face this more frequently.
The condition of the body changes based on the location and type of public or private services. In fact, private and public affairs each impose special conditions on the pregnant woman's body.
We also followed the course of emotional evolution of hospitalized pregnant women in public sector, and we argued how this path leads to an evolution in class consciousness.
The health standards can be defined based on class characteristics. Social class has an important effect on people's beliefs and attitudes towards health. The type of exposure to the delivery method, abortion treatment and disability are all different based on the social class.
And finally, in the current mechanism of human production in Tehran, choices for parents are far different from each other and consequently for their babies, both before and after birth; however, it is not only in private sphere, rather in a public and political arena between those who are expected to play an active role in building a nation and those who do not.
Ethics:
This essay is on a code of ethics; and assumed names have been assigned to maintain the anonymity of participants. The health centers are also confidential.
Type of Study: orginal |
Received: 2023/04/6 | Accepted: 2023/11/11 | Published: 2024/05/3
Received: 2023/04/6 | Accepted: 2023/11/11 | Published: 2024/05/3
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