What are the political dimensions that are revealed in women’s preferences for health care during pregnancy and childbirth? The answers to this question vary from one community to the next, and often from woman to the next, although the trends in the Global North and South are strikingly different.
Employing three conceptual frames; medicalization, the public-private distinction, and intersectionality, Candace Johnson examines these differences through the narratives of women in Canada, the United States, Cuba, and Honduras. In Canada and the United States, women from privileged and marginalized social groups demonstrate the differences across the North-South divide, and women in Cuba and Honduras speak to the realities of severely constrained decision-making in developing countries. Each case study includes narratives drawn from in-depth interviews with women who were pregnant or who had recently had children. Johnson argues that women’s expressed preferences in different contexts reveal important details about the inequality that they experience in that context, in addition to as various elements of identity. Both inequality and identity are affected by the ways in which women experience the division between public and private lives – the life of the community and the life of the home and family – as well as the consequences of intersectionality – the combinations of various sources of disadvantage and women’s reactions to these, either in the form of resistance or compliance.
The rigorous and highly original cross cultural and comparative research on health, gender, poverty and social context makes Maternal Transition an excellent contribution to global maternal health policy debates.
"This unique study comparing women from the global north and south transcends the binary model that says the medicalization of birth is either oppressive or liberating. Through cross-cultural, in-depth interviews with women from Cuba, Honduras, Canada, and the United States Johnson skillfully demonstrates how women’s preferences for health care during pregnancy and childbirth are shaped by their race, class, and gender positions."
—Iris Lopez, CUNY-City College, author of Matters of Choice: Puerto Rican Women’s Struggle for Reproductive Freedom
"Through thoughtful and sensitive interviews, Candace Johnson enables women to tell their own stories about health, reproductive decision-making and bodily agency. Incorporating feminist theories and research methods, Maternal Transition analyzes these narratives within the contexts of local history, culture and politics. Dr. Johnson examines the background assumptions in maternal health care and healthy women programs which structure the decisions women make during pregnancies and childbirths. She also documents the silences in healthy women programs regarding charged choices such as terminating a pregnancy safely and legally. Maternal Transitions should be required reading for public health, women’s studies, and global politics scholars and practitioners."
—Laura Woliver, University of South Carolina
1. Introduction Part I: Generating Theory 2. Intersectionality and Complex Inequality 3. The Political Nature of Pregnancy and Childbirth 4. Maternal Citizenship and Mother Virtue 5. Negotiating Maternal Identity Part II: Comparing North-South Cases 6. Canada: Maternal Health and Diversity 7. The United States: Birth at the Border 8. Cuba: Between Resistance and Compliance 9. Honduras: Birth and Death in Copán 10. Conclusion