Robbie Davis-Floyd on Coersion and Choice

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By Jill—Unnecesarean

I just read an article by Robbie Davis-Floyd that originally appeared in Anthropology News titled “Anthropology and Birth Activism: What do we Know?” Here’s a fairly hefty excerpt of the full article, which can be found here.

In contrast to women’s Third Worldly experiences, American women seem to have all the choice and agency in the world. These choices and agencies are the result of real struggles by resourced activists, from contemporary middle-class women seeking to bring humanism to technocratic birth, back to the Boston upper-crust ladies who worked hard in the 1920s to bring scopolamine from Germany to the U.S. and to convince doctors to use it. Such choices were for decades denied to the American poor and underserved (who were “supposed to suffer”), who then turned around to demand all the technology they could get as soon as they had access to it. Because the privileged women had it, they “knew” it was the best.

Now that knowledge blankets the planet, convincing women that they should want techno-birth, and justifying its infliction if they don’t. What is choice and privilege in one setting becomes an almost invisible coercion in another. What obstetricians know is that women are choosing drugs and technology, so forcing drugs and technology on women who don’t choose them can be easily coded as “giving women what they want” and “respecting a woman’s choice.” Choice in the “First” World — the world of the resource-rich in every country — paradoxically serves to obscure and mystify coercion in the Third World of resource-poor.

Doctors “know” that they are giving women “the best care,” and “what they really want.” Birth activists, including myself, know that this “best care” is too often a travesty of what birth can be. And yet on that existential brink, I tremble at the birth activist coding of women as “not knowing.” So much anthropological research on reproduction highlights the carefully thought-out strategies behind the decisions women make within the context of their lived realities — an insight that must apply as equally to the American woman who schedules a cesarean as to the Tanzanian woman who returns to the traditional midwife. Teasing out the difference between birth activism and anthropology, I return to the core of our discipline: birth ethnographers only really know what the women they study show and tell them. It is our job to specify, contextualize, and render meaningful the choices these women make in all their diversity, so that we can tell the world what women know. [Emphasis mine]

Hat tip and big thanks to