This week’s reading on Labor, Privatization and Class opened my eyes to the differences socially and culturally between America and various countries. Notably, there exists a high importance of intra-household hierarchies and the division of labor between family members in countries such as India, while in America there exists a more relaxed and malleable description of family life. The case study in Calcutta, India shows that domestic and kin relationships affect a pregnant woman’s access, use and knowledge of the healthcare system. The common trend found among pregnant women in India show a high percentage giving birth in a private institution as well as a high percentage of women having elective C-sections. This was shown to be more prevalent in middle- and high-class families, as well as in urban verses rural areas. I found it interesting that more women choose private birth centers over hospitals, given our recent class discussion of birthplace ranging from hospital, birth center, and home birth. Notably, the chapter bases these decisions on Indian women’s lack of trust and credibility of hospitals, whereas birth centers give the comfort and personal interest in wellbeing that the women are looking for. In addition, modern technology is seen as a blessing, and a way to enable a healthy infant born at a suitable time for the parents. It is shown as a prestigious technique, allowing women to avoid pain, shame and the cultural belief in pollution that follows a natural vaginal birth. In 2012, research shows that in Indian private institutions women are 3 to 10 times more likely to have an elective C-section than in hospital settings. In comparison to the US, more elective C-sections occur at hospitals than private institutions. The difference in these statistics may be due to differences in the wishes of pregnant women, who may prefer C-sections more in India than in the US. However, I believe this difference may be based on the characteristics of women who choose to give birth in each setting, while in the US most women attend a hospital birth women in India prefer a private institution and thus have different expectations of care.
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I found the statistic stating that Indian women delivering in private practices are more likely to have a C-section very interesting! I agree that this has a lot to do with expectations of care. From the RAMS reading, I got the sense that the desire for C-sections was rooted in the desire for “luxurious” things and identification with class. However, I don’t think these outcomes are always a result of the individual wishes of the pregnant women. For example, as the case in the reading, parents-in-law will often control the way a pregnant woman delivers.
I think this was a great post with the way that you paid due respect to cultural differences. One point that you made that stuck out with me was the fact of Indian women wanting an institutional birth because of the technology available. My parents both emigrated from Nigeria, My mother lived in both the village and the city while my father only lived in the village before coming to the US. My parents experienced very traditional births with low resources. Both of my parents have lost multiple siblings and relatives in childbirth or infancy. So, when came time for my mother to have children in the US she opted for a hospital birth for all of us and did not think twice about it. When you have come from a place of high rates of infant mortality and poor birth outcomes you will see hospital and birthing centers as a way to provide the best outcomes for your children with the technology and resources. The stress of family responsibility as well as a pronounces lower place in society creates unnecessary stigma for these Indian women which influence the choices they make about their birth.
Hi Hannah, one of the main things I gathered about the rates of C-sections in India was that it not only offered the women a birthing method that allowed them to avoid pain, shame and the cultural belief in pollution that comes with a vaginal birth, but also a way to challenge intra-household hierarchies and the division of labor. When women in Calcutta would have a C-section they were not only getting to better negotiate reproductive technology, but were also getting a longer rest period after birth. This medicalisation of birth gave the women control over certain privileges. In some cases, as with Madhushree Chowdhury, the women are able to return to their family’s homes where they are cared for and have smaller work loads. This increase in control of pre and post birth decisions and their own bodies may be a driving force for the women to undergo C-sections.