Date of Award

5-4-2021

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Sociology

First Advisor

Wendy Simonds

Second Advisor

Elisabeth O. Burgess

Third Advisor

Katie Acosta

Abstract

My study investigates the contemporary global concept of obstetric violence. This concept originated in Venezuela in conjunction with the movement to humanize birth. At the same time, global public health initiatives to combat maternal mortality increased the number of facility-based births internationally with unintended consequences. I use content analysis of popular and peer-reviewed texts, podcasts, and in-depth interviews with birthing people and birth service providers to explore the ways various groups define, understand, and are using this term. I also investigate the ways autonomy and medical authority interact during institutional birth. My methods include illuminating cultural influences and focusing on the everyday behaviors and strategies that people utilize during hospital birth to propagate and resist violence in obstetrics in the U.S. and beyond. Assumptions of class and "belonging" intertwine with perinatal violence connected to discrimination based on race and indigeneity worldwide. Supremacist beliefs reproduced in the medical industrial complex prioritize babies, shut down the voices and agency of birthing people, and uphold institutional strategies that involve withholding information, unconsented procedures, and medical entrapment. These data indicate that centering reproductive and birth justice frameworks is especially important in moving towards a reimaging of birth as normal and birthing people as capable and competent both in and outside the hospital. Programs and policies modeled on existing community-based work are crucial to address issues of medical access and excess for pregnant and birthing people. These include promoting education and autonomy through outreach during pregnancy; implementing protocols of continuous care and consent during facility-based birth for effective communication at all levels; increasing accountability for providers/institutions related to rates of cesarean, induction, discrimination, and mistreatment; creating linkages between providers/institutions and the communities they serve; and fostering a team-based atmosphere of supportive engagement among all stakeholders.

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