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Competing technologies, cont.

What is, in fact, the state of birth around the world? What do social anthropologists working in this field say?

"For decades, the World Health Organization, national ministries of health and philanthropic organizations have been engaged in the "upgrading" of perinatal services in developing regions. These efforts include the importation of high-tech obstetric technology and of technology-dependent obstetric procedures such as hospital deliveries, pharmacologically managed labors, the use of ultrasound and electronic fetal monitoring, induction of labor, instrumental and surgical delivery, and the care of premature and sick infants in intensive care units. Yet, after all these years, maternal and neonatal mortality and morbidity rates are still unconscionably high, in part due to negative consequences of an overzealously applied biomedical approach."

There is no doubt that surgery and pharmacology can save lives -- that is not an issue here. There will always be cases where a cesarean section saves the life of a mother and baby. But do 30% or 60% of births have to end in C-sections, as in the case in countries like Costa Rica, Brazil and China?"

"In general, women in developing countries (at least until Western medicine dictates otherwise) labor and give birth in upright or semi-upright positions, such as sitting, squatting, half-reclining, kneeling or standing -- often using several of these positions in sequence. The combination of upright posture with frequent position changes and the assumption of asymmetrical positions facilitate the mechanism of labor that affects the passage of the baby's body through the birth canal. ... Complications such as changes in fetal heart rate or dystocia can frequently be remedied by changes in position." The authors describe a bias towards the high-tech machines even when they are not medically necessary because of the perceived authoritative power such machines have usurped around the world. Where cosmopolitan high-tech facilities are available, it is never the case that women are referred to low-tech programs even if these are cheaper and more accessible, such as walking and resting when labor slows down in preference to oxytocin injections, or mother-baby co-sleeping for premature newborns in preference to incubators. [View source]

from Jordan, Brigitte and Thatcher, Anastasia, "Competing Technologies in Perinatal Care: a Call for Dialogue between Low- and High-Tech Practitioners, Anthropology News, March 2009, pg.5-6


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