Partner-Accompanied and Individual Care Providers in the Setting of COVID-19 Pandemic: Power Decisions, Practices and Discourses

 
Код статьиS086954150017611-2-1
DOI10.31857/S086954150017611-2
Тип публикации Статья
Статус публикации Опубликовано
Авторы
Аффилиация: National Research University Higher School of Economics
Адрес: Russian Federation, Moscow
Название журналаЭтнографическое обозрение
Выпуск№6
Страницы294-313
Аннотация

The article analyzes field materials and regulatory documents representing childbirth with support of a partner, individual midwife and doula accompaniment since the beginning of the COVID-19 pandemic, as well as strategies for interaction of patients, their families and personal assistants with maternity hospitals in the context of anti-epidemic restrictions of the Rospotrebnadzor and recommendations of the Ministry of Health of the Russian Federation. In larger Russian cities, the possibility of extraterritorial choice of an obstetric hospital has been limited. Physicians are forced to act on the basis of the presumption of COVID-positive status in pregnant women, women in labor, infants and other caregivers. In maternity hospitals, the practice of family- / partner- and doula-provided assistance was temporarily suspended, and physical separation of the mother from the newborn was recommended, including that in children’s intensive care. However, the conspiracy and eschatological discourses of the lay people and the academic establishment, fears of asceticism and of “canceling thy neighbor,” a return to “bare life,” the supremacy of biopower, loss of rituals of childbirth and funeral were overcome by individual specialists and practices of continuing life itself. Epidemic-control restrictions forced them to transfer interactions with women into forms uncontrollable and invisible to the state and provide support for home births, online support in maternity hospitals, (un)paid prenatal and postnatal counseling and rehabilitation.

Ключевые словаPartner-accompanied childbirth, individual midwife, doula, patient choice, informed consent, patient rights, medicalization, COVID-19, restrictive measures, quarantine, emergency government regulation
Источник финансированияThis article is a translation of: Т.Л. Кукса. Партнерские роды и индивидуальные сопровождения в условиях COVID-19: властные решения, практики и дискурсы // Etnograficheskoe Obozrenie. 2021. No 6. P. 39–61. DOI: 10.31857/S086954150017932-5
Получено20.12.2021
Дата публикации23.12.2021
Кол-во символов71736
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1 Theoretical framework, sources and methods
2 Conventional, media and academic interpretation of COVID-19’s effect on people are dwelled upon in many a recent anthropological work (Bakhmatova 2020; Kirziuk 2021; Manichkin 2021; Kharitonova 2020). In these papers, the researchers interpret the initial response to newly introduced anti-pandemic measures either from the perspective characteristic of European establishment, operating on concepts introduced by Agamben and Foucault (Manichkin 2021), or from the point of view held by ordinary Petersburgers prone to “moderate” or “radical” COVID-19 dissent (Kirziuk 2021). Nestor Manichkin mostly dwells on the European academic media dispute concerning Giorgio Agamben’s radically critical views of emergency regulations imposed by the states1, the consequences of the newly introduced “biosafety” requirements and the “sanitary terror”2 that led to a “religious cult of medicine”3, social distancing4, “canceling thy neighbor”5 and “facelessness”6, “technical barbarity” of studying from home7, giving up culture, rights and values in favor of physical survival and “bare life”8 (Manichkin 2021; Agamben 1998). Anna Kirziuk places dissent into a conspiracy frame and examines semi-structured interviews with the denizens of St. Petersburg concerning their disregard of the restrictive measures. Employing the concepts of “stigmatized knowledge” (Barkun 2015) and “agency panic” (Melley 2000, 2008), Kirziuk portrays both the “moderate” and the “radical” COVID-19 denier in Russia, explaining the “pessimistic” roots of anti-“system” resistance via insufficient agency and pre-pandemic fondness of “alternative”, paramedical and other “stigmatized” conspiracy theories (Kirziuk 2021; Barkun 2015; Melley 2000, 2008). 1. >>>>

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3 Nevetheless, the abovementioned works leave aside the normative content, legal sufficiency and the logics of implementation of emergency epidemic-control measures and the multitude of personae who adopt the controversial governmental decrees (for example, see more on this in: Kuksa 2020a, 2020b), as well as the analysis of the legislative and regulatory compliance practices (aside from discursive practices) and scenarios of medical and patient decision-making during the COVID-19 pandemic. With few exceptions (see, for example: Kuksa 2020a, Kharitonova 2020), Russian scholarly literature on the matter tends to leave aside anthropological analysis of how Russian professional communities and human rights advocacy groups react to massive epidemic-control measures that involve restrictions on the rights of both medical professionals and patients, including obstetric patients and their families. On the contrary, some recent works by Western medical anthropologists explore the specifics of limiting the agency of pregnant women and new mothers as a result of state policies of health preservation and of epidemic-control measures implemented by governments and hospitals (Barata et al. 2020; Castaneda, Searcy 2020; Declan et al. 2020; Quagliariello, Grotti 2020; Rivera 2020; Rocca-Ihenacho, Alonso 2020; Varley, Strong 2020; Yuill et al. 2020).
4 This article focuses on field materials and regulations concerning partner-accompanied births, midwifery and doula-assisted support since the outbreak of the coronavirus pandemic, as well as the bureaucratic and communicative contexts and strategies of interaction between obstetric patients, their family members and trained companions with maternity clinics under the epidemic-control measures implemented by the Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) and the Ministry of Health of the Russian Federation.
5 The specifics of the functioning of maternity wards during the pandemic, partner- and doula-accompanied births temporarily put on hold and then selectively reinstalled in larger Russian cities, bodily restraints and legal restrictions, the discursive reaction of medical, obstetric, doula and patient networks towards the medicalization cannot, in my opinion, be properly explored apart of the content of policies of health preservation, restrictive epidemic-control measures and “punishment” forms of administrative and judicial control. Therefore, an analysis of normative legal and administrative documents and guidance materials related to reproductive and/or patient choice precedes my further elaborations, as further filling of the gaps in the interpretation of numerous (and often contradicting) bureaucratic logics of the government authorities adopting extraordinary anti-COVID resolutions is in order (Kuksa 2020a, 2020b, 2021). Accordingly, five relevant federal laws have been analyzed in this article along with the four versions of the guidelines that have been issued by the Ministry of Health since the start of the pandemic, 14 resolutions, 26 mandatory guidelines and more than 100 non-regulatory documents issued by the Rospotrebnadzor, all aimed at 2019-nCoV contagion prevention.

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