Doctoral Dissertation Research: Understanding Maternity Care Decisions

医学社会学的研究表明，在过去的一个世纪里，妇女关于产妇护理和生育的决定已经变得受到医疗技术和医疗权威的高度制约。与此同时，各种社会运动，包括自然分娩运动和健康消费主义，使妇女更容易看到和获得替代分娩选择。总而言之，分娩的当代背景提供了一个机会，以审查妇女在做出健康决定时如何以及以何种方式驾驭和分配竞争类型的知识的价值。在这篇论文中，研究人员将对从未生育过的孕妇进行深入访谈，以了解影响女性生育态度的个体层面的影响，特别是社会关系、种族和社会阶层如何以及以何种方式影响女性的生育态度和她们对生育的决定。这个项目涉及社会学的几个领域，并以具体的方式推进知识。首先，这项研究建立在医学社会学文献的基础上，特别是关于医学化的研究，背离了主要的“医学与自然”框架，以理解为什么妇女做出特定的产妇健康决定。虽然许多研究只考察了关于出生的决定是在更大的背景下做出的，但这项研究将阐明个人对出生的态度是如何形成的，以及个人层面的现象如何与关于出生的主流话语相交。其次，该项目将通过探索个人与他人的互动在塑造医疗决策中的作用，为社会关系研究做出贡献。许多对妇女产前和产后经历的研究侧重于社会支持在塑造健康结果方面的作用，但这个项目将分析社会关系的各种动态，包括社会影响发生的方式，以及在医疗化的背景下可能产生的影响。最后，研究女性的医疗保健行为将使这项研究能够通过探索女性气质和好母亲的观念如何影响高度性别的怀孕和分娩体验，从而使这项研究能够与性别和家庭的社会学研究对话。

Medical sociology research suggests that over the past century women's decisions about maternity care and birth have become highly constrained by medical technology and medical authority. Concurrently, various social movements, including the natural childbirth movement and health consumerism, have made alternative birthing options more visible and available to women. Taken together, the contemporary context of childbirth provides an opportunity to examine how, and in what ways, women navigate and assign value to competing types of knowledge when making health decisions. In this dissertation project, the researcher will conduct in-depth interviews with pregnant women who have never before given birth to understand the individual level influences that shape women's attitudes about birth, specifically how, and in what ways, social relationships, race, and social class influence women's attitudes about birth and their decisions about maternity care. This project engages several areas of sociology and advances knowledge in concrete ways. First, the research builds on medical sociology literature, particularly research on medicalization, by departing from the dominant "medical versus natural" framework for understanding why women make particular maternity health decisions. Whereas many studies examine only the larger context in which decisions about birth are made, this research will elucidate how individuals' attitudes about birth are shaped, and in what ways individual-level phenomenon intersect dominant discourse about birth. Second, this project will contribute to research on social relationships by exploring the role of individuals' interactions with others in shaping healthcare decisions. Many studies examining prenatal and postnatal experiences of women focus on the role of social support for shaping health outcomes, but this project will analyze the various dynamics of social relationships including the ways in which social influence occurs and how that may matter in the context of medicalization. Finally, examining women's health care behaviors will allow enable this research to speak to sociological research on gender and family by exploring ways in which notions of femininity and good mothering impact the highly gendered experience of pregnancy and childbirth.