Multi-layered risk management in under-resourced antenatal clinics
- Feltham-King, Tracey, Macleod, Catriona I
- Authors: Feltham-King, Tracey , Macleod, Catriona I
- Date: 2020
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/298561 , vital:57716 , xlink:href="https://doi.org/10.1080/13698575.2019.1697432"
- Description: In this article we contribute to critical risk approaches to studying pregnancy and childbirth in the global South. Following Sarah Rudrum’s work, our approach focusses on sociocultural inequalities amid the regulation of individuals. We draw on data from our Foucauldian-inspired ethnography of two antenatal clinics in an under-resourced area of South Africa to illustrate how multi-layered risk management operates in these spaces. These data were collected over a period of six months in the form of semi-structured interviews, observations of consultations and waiting room interactions, documents used in the clinic, and posters appearing on the clinic walls. Our findings show how a scientific-bureaucratic approach to pregnancy risk management, as encoded in international, national and institutional guidelines, is well known, highly visible, and practised through surveillance and reporting mechanisms in clinics. This approach incites healthcare practitioners to achieve particular performance standards and to monitor their professional agency. Managing pregnancy risk thus entails regulating the healthcare practitioners themselves. In implementing approved pregnancy risk management strategies in an over-subscribed and under-resourced public healthcare setting, however, healthcare practitioners face potential risk to their professional reputation and integrity. In managing this risk, they resist the scientific-bureaucratic approach through: depicting themselves as victims of unfair institutional arrangements or unreasonable patients; instituting street-level bureaucracy to control access to the clinics; and controlling patients’ actions in authoritarian ways. Our research shows that without engagement with the on-the-ground realities of the antenatal clinic in resource-poor environments, a scientific-bureaucratic approach to pregnancy risk management is inevitably limited in its effectiveness.
- Full Text:
- Date Issued: 2020
- Authors: Feltham-King, Tracey , Macleod, Catriona I
- Date: 2020
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/298561 , vital:57716 , xlink:href="https://doi.org/10.1080/13698575.2019.1697432"
- Description: In this article we contribute to critical risk approaches to studying pregnancy and childbirth in the global South. Following Sarah Rudrum’s work, our approach focusses on sociocultural inequalities amid the regulation of individuals. We draw on data from our Foucauldian-inspired ethnography of two antenatal clinics in an under-resourced area of South Africa to illustrate how multi-layered risk management operates in these spaces. These data were collected over a period of six months in the form of semi-structured interviews, observations of consultations and waiting room interactions, documents used in the clinic, and posters appearing on the clinic walls. Our findings show how a scientific-bureaucratic approach to pregnancy risk management, as encoded in international, national and institutional guidelines, is well known, highly visible, and practised through surveillance and reporting mechanisms in clinics. This approach incites healthcare practitioners to achieve particular performance standards and to monitor their professional agency. Managing pregnancy risk thus entails regulating the healthcare practitioners themselves. In implementing approved pregnancy risk management strategies in an over-subscribed and under-resourced public healthcare setting, however, healthcare practitioners face potential risk to their professional reputation and integrity. In managing this risk, they resist the scientific-bureaucratic approach through: depicting themselves as victims of unfair institutional arrangements or unreasonable patients; instituting street-level bureaucracy to control access to the clinics; and controlling patients’ actions in authoritarian ways. Our research shows that without engagement with the on-the-ground realities of the antenatal clinic in resource-poor environments, a scientific-bureaucratic approach to pregnancy risk management is inevitably limited in its effectiveness.
- Full Text:
- Date Issued: 2020
Young pregnant women and public health
- Macleod, Catriona I, Feltham-King, Tracey
- Authors: Macleod, Catriona I , Feltham-King, Tracey
- Date: 2020
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/298572 , vital:57717 , xlink:href="https://doi.org/10.1080/09581596.2019.1573313"
- Description: In this paper, we outline a critical reparative justice/care approach to adolescent reproductive health as an alternative to the standard public health response to ‘teenage pregnancy’. Joining an increasing body of critical scholarship that calls for nuance in understanding reproduction amongst young people, we draw, in this paper, on data generated from an ethnographic study conducted in antenatal care units in an Eastern Cape township in South Africa. To illustrate the approach we propose, we home in on five case studies that highlight the variability of young women’s lives, the multiple injustices they experience, and the agency they demonstrate in negotiating their way through pregnancy and birth. Injustices evident in these cases centre on sexual violence, rape myths, education system failures, health system failures, shaming and stigmatising practices, socio-economic precariousness, absent male partners, and denial of services. We outline how the reparative justice approach that highlights repair and support for social and health injustices at the individual and collective level as well as at the material and symbolic level may be taken up to ensure reproductive justice for young pregnant women.
- Full Text:
- Date Issued: 2020
- Authors: Macleod, Catriona I , Feltham-King, Tracey
- Date: 2020
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/298572 , vital:57717 , xlink:href="https://doi.org/10.1080/09581596.2019.1573313"
- Description: In this paper, we outline a critical reparative justice/care approach to adolescent reproductive health as an alternative to the standard public health response to ‘teenage pregnancy’. Joining an increasing body of critical scholarship that calls for nuance in understanding reproduction amongst young people, we draw, in this paper, on data generated from an ethnographic study conducted in antenatal care units in an Eastern Cape township in South Africa. To illustrate the approach we propose, we home in on five case studies that highlight the variability of young women’s lives, the multiple injustices they experience, and the agency they demonstrate in negotiating their way through pregnancy and birth. Injustices evident in these cases centre on sexual violence, rape myths, education system failures, health system failures, shaming and stigmatising practices, socio-economic precariousness, absent male partners, and denial of services. We outline how the reparative justice approach that highlights repair and support for social and health injustices at the individual and collective level as well as at the material and symbolic level may be taken up to ensure reproductive justice for young pregnant women.
- Full Text:
- Date Issued: 2020
‘Adolescent Pregnancy’ 1: Social problem, public health concern, or neither
- Macleod, Catriona I, Feltham-King, Tracey
- Authors: Macleod, Catriona I , Feltham-King, Tracey
- Date: 2019
- Subjects: To be catalogued
- Language: English
- Type: text , book chapter
- Identifier: http://hdl.handle.net/10962/434031 , vital:73027 , ISBN 9781351035620 , https://www.taylorfrancis.com/chapters/edit/10.4324/9781351035620-17/adolescent-pregnancy-1-catriona-ida-macleod-tracey-feltham-king
- Description: In this chapter we outline three major approaches to adolescent pregnancy. The first is the ‘social problem’ approach, in which adolescent pregnancy is viewed as, for the most part, deleterious for the young woman, her offspring, and society. This position fuels public outrage when the numbers of pregnant adolescents (especially when they are school pupils) are revealed in newspapers. The second is a public health response, which is well established and which has much institutional kudos. Here the neutral language of population-wide health is used to underpin preventive efforts in relation to adolescent pregnancy. In the third approach, authors point to the problems underlying both of these positions, arguing that arbitrarily separating younger pregnant women from older pregnant women is premised on particular power relations.
- Full Text:
- Date Issued: 2019
- Authors: Macleod, Catriona I , Feltham-King, Tracey
- Date: 2019
- Subjects: To be catalogued
- Language: English
- Type: text , book chapter
- Identifier: http://hdl.handle.net/10962/434031 , vital:73027 , ISBN 9781351035620 , https://www.taylorfrancis.com/chapters/edit/10.4324/9781351035620-17/adolescent-pregnancy-1-catriona-ida-macleod-tracey-feltham-king
- Description: In this chapter we outline three major approaches to adolescent pregnancy. The first is the ‘social problem’ approach, in which adolescent pregnancy is viewed as, for the most part, deleterious for the young woman, her offspring, and society. This position fuels public outrage when the numbers of pregnant adolescents (especially when they are school pupils) are revealed in newspapers. The second is a public health response, which is well established and which has much institutional kudos. Here the neutral language of population-wide health is used to underpin preventive efforts in relation to adolescent pregnancy. In the third approach, authors point to the problems underlying both of these positions, arguing that arbitrarily separating younger pregnant women from older pregnant women is premised on particular power relations.
- Full Text:
- Date Issued: 2019
‘Failed’ mothers, ‘failed’ womxn
- Macleod, Catriona I, Feltham-King, Tracey, Mavuso, Jabulile M-J J, Morison, Tracy
- Authors: Macleod, Catriona I , Feltham-King, Tracey , Mavuso, Jabulile M-J J , Morison, Tracy
- Date: 2019
- Subjects: To be catalogued
- Language: English
- Type: text , book chapter
- Identifier: http://hdl.handle.net/10962/434050 , vital:73028 , ISBN 9781032082967 , https://www.routledge.com/Intersections-of-Mothering-Feminist-Accounts/Zufferey-Buchanan/p/book/9781032082967
- Description: Mothering occurs within unequal power relations associated with the disadvantages and privileges of an unjust and patriarchal society. Social inequalities associated with gender, race, class, age, ability, sexuality, violence and nationalism intersect in the lives of women as mothers, to shape their lived experiences and perspectives on mothering. Showcasing the breadth and depth of feminist research on mothering, this book gives attention to the diversity of ways in which mothering is constructed and responded to as well as how mothering is experienced. Drawing on intersectional feminist thought, the book challenges normative visions of ‘good mothering’ and interrogates constructs of ‘bad mothering’. It brings together insights from multidisciplinary scholars who use feminist approaches in their research on mothering, to inform policy development and practice when working with women as mothers in diverse circumstances. Intersections of Mothering highlights the complexities of mothering in a contemporary world, show the benefits of considering mothering through an intersectional feminist lens, make visible lived experiences of mothers and provides challenges to dominant imaginings of and service responses to women as mothers.
- Full Text:
- Date Issued: 2019
- Authors: Macleod, Catriona I , Feltham-King, Tracey , Mavuso, Jabulile M-J J , Morison, Tracy
- Date: 2019
- Subjects: To be catalogued
- Language: English
- Type: text , book chapter
- Identifier: http://hdl.handle.net/10962/434050 , vital:73028 , ISBN 9781032082967 , https://www.routledge.com/Intersections-of-Mothering-Feminist-Accounts/Zufferey-Buchanan/p/book/9781032082967
- Description: Mothering occurs within unequal power relations associated with the disadvantages and privileges of an unjust and patriarchal society. Social inequalities associated with gender, race, class, age, ability, sexuality, violence and nationalism intersect in the lives of women as mothers, to shape their lived experiences and perspectives on mothering. Showcasing the breadth and depth of feminist research on mothering, this book gives attention to the diversity of ways in which mothering is constructed and responded to as well as how mothering is experienced. Drawing on intersectional feminist thought, the book challenges normative visions of ‘good mothering’ and interrogates constructs of ‘bad mothering’. It brings together insights from multidisciplinary scholars who use feminist approaches in their research on mothering, to inform policy development and practice when working with women as mothers in diverse circumstances. Intersections of Mothering highlights the complexities of mothering in a contemporary world, show the benefits of considering mothering through an intersectional feminist lens, make visible lived experiences of mothers and provides challenges to dominant imaginings of and service responses to women as mothers.
- Full Text:
- Date Issued: 2019
Contesting the nature of young pregnant and mothering women: Critical healthcare nexus research, ethics committees, and healthcare institutions
- Feltham-King, Tracey, Bomela, Yolisa, Macleod, Catriona I
- Authors: Feltham-King, Tracey , Bomela, Yolisa , Macleod, Catriona I
- Date: 2018
- Subjects: To be catalogued
- Language: English
- Type: text , book chapter
- Identifier: http://hdl.handle.net/10962/434199 , vital:73038 , ISBN 978-3-319-74720-0 , https://link.springer.com/chapter/10.1007/978-3-319-74721-7_5
- Description: In this chapter we describe how systemic contradictions complicate ethical site entry and data collection in critical research. We present our ethnographic research within South African antenatal and postnatal clinics as an example. Pregnant and mothering young women are subject to diverging views of minors in different state-produced policies and legislation. In addition, we encountered discrepancies between our research aims and assumptions made by the University Ethical Standards Committee, managers, healthcare providers, teenaged participants, and other service users. These complexities have implications for ethical engagement of researchers and call for nuanced means of data collection and analysis. We discuss how critical researchers can mitigate social injustice by questioning entrenched ways of thinking about participants and negotiating the contradictory positionings of self and others.
- Full Text:
- Date Issued: 2018
- Authors: Feltham-King, Tracey , Bomela, Yolisa , Macleod, Catriona I
- Date: 2018
- Subjects: To be catalogued
- Language: English
- Type: text , book chapter
- Identifier: http://hdl.handle.net/10962/434199 , vital:73038 , ISBN 978-3-319-74720-0 , https://link.springer.com/chapter/10.1007/978-3-319-74721-7_5
- Description: In this chapter we describe how systemic contradictions complicate ethical site entry and data collection in critical research. We present our ethnographic research within South African antenatal and postnatal clinics as an example. Pregnant and mothering young women are subject to diverging views of minors in different state-produced policies and legislation. In addition, we encountered discrepancies between our research aims and assumptions made by the University Ethical Standards Committee, managers, healthcare providers, teenaged participants, and other service users. These complexities have implications for ethical engagement of researchers and call for nuanced means of data collection and analysis. We discuss how critical researchers can mitigate social injustice by questioning entrenched ways of thinking about participants and negotiating the contradictory positionings of self and others.
- Full Text:
- Date Issued: 2018
- «
- ‹
- 1
- ›
- »