Category / Sociology & Social Policy

Congratulations to PhD student Rachel Arnold

HSC postgraduate student Rachel Arnold just had the first paper from her research in Afghanistan accepted by the scientific journal BJOG.  Her paper analyses the culture of a Kabul maternity hospital to understand its impact on the care of perinatal women and their babies.    A heavy workload, too many complicated cases and poor staff organisation lead to a low quality of maternity care. Cultural values, social and family pressures influenced the motivation and priorities of healthcare providers.

The centrality of the family and family obligations in Afghan society has emerged as a major theme. Another theme is the struggle for survival – as health care providers work to support their families, to maintain the power that they have, and to survive within a hospital system where fear rather than compassion appears to drive and motivate.  Rachel presented some of the key issues at the 2013 GLOW conference in Birmingham.   Rachel is supervised by Professors Immy Holloway, Kath Ryan (LaTrobe University, Australia) and Edwin van Teijlingen.

Rachel’s paper Understanding ‘Afghan healthcare providers: a qualitative study of the culture of care in a Kabul maternity hospital’ can be found here.  The paper is Gold Open Access.

 

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health

Congratulations to Dr Sarah Hean & colleagues!

Congratulations to Dr. Sarah Hean in the School of Health & Social Care and her colleagues Staddon, Clapper, Fenge, Heaslip and Jack on the acceptance of their article: ‘Improving Collaborative Practice to Address Offender Mental Health: Criminal Justice and Mental Health Service Professionals’ Attitudes Towards Interagency Training, Current Training Needs and Constraints’ by the Journal of Research in Interprofessional Practice and Education.

 

The paper is Open Access funded by BU!  A copy is available in BU’s repository BURO: http://eprints.bournemouth.ac.uk/21462/

 

Well done

 

Prof. Edwin van Teijlingen

CMMPH

Paper added to CEL collection

 

The latest paper of BU’s Centre for Excellence in Learning (CEL) was published in the Nepal Journal of Epidemiology.  The lead author Padam Simkhada (BU Visiting Faculty) together with BU’s Edwin van Teijlingen and three academic colleagues in Nepal published their paper: ‘Accessing research literature: A mixed-method study of academics in Higher Education Institutions in Nepal’ [1].

This latest paper reports on the knowledge of and practice in accessing electronic research-based evidence among university teachers in the health and medical field in Nepal.  This paper originates from a recently finished DelPHE (Round 4), British Council: award.  The study called Partnership on Improving Access to Research Literature for HE Institutions in Nepal (PARI Initiative) was a collaboration between Tribhuvan University, Kathmandu, Nepal, the University of Sheffield and BU’s School of Health & Social Care.   This is the second paper to appear from the PARI study, the first paper reported on research methods teaching [2].

The paper argues that accessing electronic research literature provides an opportunity to gathering up-to-date research-based information that should be core to all health curricula in Nepal.  The authors call upon curriculum developers and university authorities in Nepal to revise health curricula and help build electronic searching skills among staff and students.

The Nepal Journal of Epidemiology is a full Open Access journal which means anybody across the globe can access it for free.

 

References:

  1. Simkhada, P., van Teijlingen, E., Devkota, B., Pathak, R.S., Sathian, B. (2014) Accessing research literature: A mixed-method study of academics in Higher Education Institutions in Nepal, Nepal Journal of Epidemiology 4(4): 405-14. http://www.nepjol.info/index.php/NJE/article/view/11375
  2. Simkhada, P., van Teijlingen, E., Pokharel, T., Devkota, B., Pathak, R.S. (2013) Research Methods Coverage in Medical & Health Science Curricula in Nepal, Nepal Journal Epidemiology 3(3): 253-258. www.nepjol.info/index.php/NJE/article/view/9185

Prof.  Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health
Bournemouth University

Impact, outcome and research methods – HSC PhD student on LSE Impact Blog

With working at a university and the rise of the REF, you would have almost certainly come across the terms ‘impact’ and ‘outcomes’. Whilst there might be a great deal of similarity and overlap in the use of these terms, it is important to discuss the sometime subtle differences between ‘impact’ and ‘outcome’. What consequences might this have for the design of social research?

The health and social care literature uses these terms in a rather haphazard manner. The differences are rarely discussed and it can be suggested that many use the wrong terminology. In this blog post on the LSE Impact of Social Sciences Blog, relating to the field of information and advice on welfare issues, I briefly discuss and propose that there are fundamental differences between what an impact refers to and what an outcome refers to. Furthermore, I suggest that these differences are significant and profound enough to align each to opposing research methodologies.

These thoughts relate to the key areas of my PhD project with Elderly Accommodation Counsel (EAC) in London. EAC coordinates the FirstStop service which provides information and advice to older people (and other stakeholders) on housing and care issues. My research is focused on how older people use information and advice on housing and the wider impact that this has.

If anyone has an interest in this area, do get in touch!

 

Shaping European Social Work: BU Hosts Erasmus SOCNET 98

Sara Ashencaen Crabtree & Jill Davey

 

For the first time in April 2013 BU hosted the SOCNET International University Week (IUW). This is a high profile international event held rotationally at host European universities drawn from across the 19 Higher Education Institution (HEI) members of the SOCNET community. This important annual event brings together a wide range of European academics and students with an interest in social work and social welfare.

It also provides an opportunity for HSC Social Work and Sociology & Social Policy students to interact with international academics and accompanying European students with educational, cultural and social aims in mind. During the IUW a busy series of workshops and lectures are offered based on a particular chosen theme, to which both academics and students contribute as pedagogic peers. Learning through active scholarly participation is the pedagogic approach that has proved very popular and successful over the years.

The theme of each IUW, alongside other organisational business vital to the continuation and the expansion of Erasmus SOCNET initiative, is managed at each host university in the month of October.  Consequently, the Centre of Social Work, Sociology & Social Policy was proud to host this year’s organisational event, represented by HSC Erasmus Coordinator, Jill Davey, and Sara Ashencaen Crabtree, Deputy Director of the Centre.

Attendees included academic representatives from across the SocNet-work at St. Pölten University of Applied Sciences, Austria; School of Social Work, Leuven, Belgium; University College Lillebaelt, Denmark; Hochschule Bremen – University of Applied Sciences, School of Social Work, Germany; Ernst-Abbe Fachhochschule University of Applied Sciences Jena, Germany; Department of Social Science and Care Social Work and Nursing Management, University of South Bohemia, Czech Republic; Faculty of Social and Health Studies, Telemark, Denmark;  University College, Department of Social Studies, Faculty of Health and Social Studies, Hanze University of Applied Sciences, Groningen, Netherlands; Humak University of applied sciences, Finland; University of Malaga, and finally, Bournemouth University.

A highly productive and sociable set of meetings took place over the course of several days, where, alongside discussing the European Masters in Social Work (where a UK partner is currently being identified for collaboration), the issues of venue and theme for this year’s International University Week were discussed. Since then invitations from the following four universities have been issued to academics and their students across the SOCNET community to attend the IUW (April 20th – 24th 2015) hosted by four international HEIs:

  • University College Lillebaelt – Department of Social Work. Theme: Trends in social work in the year 2015.
  • Ernst-Abbe Hochschule, University of Applied Sciences Jena. Theme:  Diversity and Innovation in European Social Work and Welfare States.
  • Telemark University College – Department of Social Studies. Theme: Diversity in Social Work.
  • Hochschule Bremen. Theme: Methods and Methodologies of Social Work – Reflecting Professional Interventions.

While the IUW clearly emphasises teaching and learning initiatives, together with internationalisation, the research element has been less publicly evident; although scholarship has always fed into the programme through the synergies between education and research.

However, over the past few years BU has altered the SOCNET landscape and is influencing the development of future trends here; where BU academics advocated for the need for high quality publications to be developed from the important lectures and workshops being annually produced in the IUW events.

Accordingly BU input has been instrumental towards developing robust academic output, which also serves to meet the BU Fusion agenda and KPIs. Thus, from the 2012 IUW at the University of Malaga, which carried the theme of ‘Active Ageing’, Professor Maria Luisa Gómez Jiménez and Professor Jonathan Parker developed the first edited SOCNET publication under London publishers, Whiting & Birch’s innovative social science monograph series, ‘Critical Studies in Socio-cultural Diversity’.

Following fast on the heels of this success, in 2013 Dr Sara Ashencaen Crabtree, proposed and developed the second edited volume from the BU event.  Moreover, in Volume II, and in keeping with the sprit of SOCNET, strong chapter contributions have featured from students from Bremen and BU (Samineh Richardson neé Hall, BA Sociology & Social Policy and PhD candidate, David Galley).

The next SOCNET publication will be forthcoming from the IUW held at Hochschule Bremen under our esteemed colleague, Professor Christian Spatscheck and colleagues. This will continue an exciting precedence, first initiated and supported to-date by BU under the Centre for Social Work, Sociology & Social Policy; a fact that we are quietly very proud of.

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Congratulations to BU Visiting Faculty on latest publication

Congratulations to Bournemouth University’s Visiting Faculty Dr. Bibha Simkhada and Prof. Padam Simkhada for the paper on financial barriers to the uptake of antenatal care in a rural community in Nepal.1   The first author (a native Nepali-speaker) conducted 50 face-to-face interviews with women and their families in rural Nepal.  These interviews were thematically analysed after transcription.

This latest paper adds to our knowledge into user costs related to maternity services in Nepal as we had already published our findings on users costs in the largest obstetric hospital in the capital. 2

 

Professor Edwin van Teijlingen

CMMPH

 

References:

  1. Simkhada, B., van Teijlingen, E.R., Porter, M., Simkhada, P. & Wasti, S.P. (2014) Why do costs act as a barrier in maternity care for some, but not all women? A qualitative study in rural Nepal International Journal of Social Economics 41 (8), 705-713

 

  1. Simkhada, P.P., van Teijlingen, E., Sharma, G., Simkhada, B., Townend, J. (2012) User costs and informal payments for care in the largest maternity hospital in Kathmandu, Nepal, Health Science Journal 6(2): 317-334.  www.hsj.gr/volume6/issue2/6212.pdf

 

Congratulations to Dr. William Haydock

 

Congratulations to William Haydock, researcher in HSC, for his recently published paper in Capital & Class 38 (3): 583-600

The paper “‘20 tins of Stella for a fiver’: The making of class through Labour and Coalition government alcohol policy” is available from: http://cnc.sagepub.com/content/38/3/583.abstract

 

Prof. Edwin van Teijlingen

CMMPH

Understanding the constructions of the ‘other’: co-produced knowledge and understanding of ‘terrorists’ and ‘terrorism’

Last year, I put together a small HEA individual grant to build upon our earlier research concerning terrorism and social work education, and civil unrest and welfare in Muslim countries. Unfortunately, the bid was unsuccessful but one should never let a good bid go to waste. Given that it was education focused, based around co-production and student enhancement – a ‘fusion’-based project! -I thought rather than try somewhere else for funding I would embed it into the third year undergraduate Sociology unit Terrorism, Protection & Society, where it would have sat if successful.

The project encourages active student engagement in learning, employing a methodology of co-production of knowledge in which skills to collaborate in producing critically informed and societally beneficial knowledge will be developed. Students are reading, critically, major UK newspapers, identifying and analysing those articles that mention ‘terrorists, terrorism or terror’ and associated concepts. From this they are engaged in identifying the processes by which our dominant cultural frames are constructed and can be challenged. The project findings, once 30-days worth of newspapers have been scoured for relevant articles, will be widely disseminated through the production of academic papers, a submission to eBU and through conference presentations.

Students following the Terrorism, Protection & Society module, engage in learning how the ‘other’, in this case ‘terrorist’, is constructed within popular debate and within the public media in the UK. As part of the project rooted within the unit, students will also analyse the media’s use of target terms (terrorist, terrorism, terror and so on) through a content and discourse analysis, and debate the potential consequences of this for contemporary society and for developing a deeper and more nuanced understanding that can assist in restraining social conflict, violence and the ‘othering’ of those who may be associated with core characteristics of ‘terrorists’ according to the socio-cultural master-narratives created by media representations.

Students will produce a paper with academic staff for the eBU on-line journal; most co-production of academic papers with students occurs at postgraduate level and this project has a degree of originality in promoting co-production of academic knowledge with undergraduate students, something we have done already in respect of edited books. Other academic outputs will be developed and students demonstrating interest and capacity will be invited to participate in their production.

Alongside the academic publications envisaged, this proposal meets BU’s fusion objectives in seeking also to add to the corpus of evidence of pedagogical benefits for students of knowledge co-creation and includes a focus on the student experience of the processes of learning.

Thus, as part of the teaching and learning students engage with, the project has wide reach and significance for student learning and pedagogical development by enhancing social and cultural understanding amongst students who will soon graduate, alongside producing autonomous and critically thinking individuals who can translate their learning and core skills into the employment market.

This week students energetically engaged with the preliminary data extraction and coding of those newspaper articles dealing with concepts and issues that were termed or could be termed as terror, terrorist, terrorism, extremism and so forth. The work undertaken helped to put in perspective some of the first two weeks’ lecture material and allowed the students to bring their own critical understandings to this complex and emotive area.

So far, the project has illuminated to me what an incredibly versatile and intellectually agile student body we have; people who will be an asset to the workforce of the future and a credit to our university! I am looking forward to the following weeks as the project unfurls.

 

Professor Jonathan Parker

 

Sociology students engaged in research

 

BU social science research on ‘Guns, Pride & Agency’

Worldwide, guns are a topic wrought with emotions. While most democratic countries consider guns in private hands a severe risk for public health if uncontrolled, it is not just in the US that licencing laws face resistance that benefit from a political and emotional rejection of state interference (e.g. UKIP’s Nigel Farage earlier this year). But why and how are ‘gun cultures’ built and sometimes sustained, even if they might undermine, an EU-led, much-desired democratisation and peace-building process after violence and war?

Dr Stephanie Schwandner-Sievers, social anthropologist at the HSC, addressed this question in her presentation ‘Guns, Pride and Agency—Albanian Ideals of Militancy Before and After the 1999 War in Kosovo’, at the international conference Comparing Civil Gun Cultures: Do Emotions Make the Difference? at the Max Planck Institute in Berlin from August 26 to 28, 2014 (https://www.mpib-berlin.mpg.de/en/research/history-of-emotions/conferences/comparing-civil-gun-cultures-do-emotions-make-the-difference). The wider ethnographic research project, on which her findings are based, was also subject of an interview earlier this year, published on a research blog of the London School of Economics: http://blogs.lse.ac.uk/lsee/2014/04/03/ilegalja-terrorists-or-freedom-fighters-an-albanian-tale-from-yugoslav-times/ .

 

Congratulations!

Prof. Edwin van Teijlingen

CMMPH

September: A good month for CMMPH publications

 

 

 

 

 

 

 

The Centre for Midwifery, Maternal & Perinatal Health started well this September with four publications in academic and practitioners’ journal.  Starting with final-year student midwife Joanna Lake who just had an article published in The Practising Midwife.1

Secondly, BU midwifery staff Jen Leamon and Sue Way together with HSC Visiting Fellow Suzie Cro also have had an article published this month in the same journal.2

Susanne Grylka-Baeschlin, a midwife from Switzerland who spent time at BU as an international visitor (see http://blogs.bournemouth.ac.uk/research/2014/07/02/latest-hsc-midwifery-paper-in-open-access/) had her paper published in BMC Pregnancy and Childbirth this month.3

And last, but not least, Wendy Marsh, based in HSC’s Portsmouth office had a paper in the September issue of the British Journal of Midwifery.4

 

Congratulations,

 

Prof. Edwin van Teijlingen

 

 

References:

  1. Lake J., 2014. Witnessing the art of woman-centred care by and exceptional mentor. The Practicing Midwife. 17(8), 24-26.
  2. Leamon J, Way S. & Cro S., 2014. Supervision of midwives and the 6Cs: exploring how we do what we do. The Practicing Midwife. 17(8), 41-42.
  3. Grylka-Baeschlin  S., van Teijlingen,  E. & Mechthild, G.M., 2014. Cultural differences in postnatal quality of life among German-speaking women: a prospective survey in two countries. BMC Pregnancy and Childbirth 14:277    www.biomedcentral.com/1471-2393/14/277
  4. Marsh, W. 2014. Removing babies from mother’s at birth: Midwives experiences. British Journal of Midwifery. 22(9):620 – 624.

Reflections on an Oasis

Our final blog concerning our Fusion Investment Funded study leave, ENABLE: Establishing Sustainable Research Networks and Building Learning Environments, is written with very mixed feelings in mind.

For seven months we have worked across Southeast Asia to develop and establish links and research collaborations, teaching and education partnerships and to rediscover our passion for social action as ‘professional practice’ associated with our disciplines. The work has been intense, tiring, sometimes frustrating, but always illuminating and productive. It was a wrench to leave.

The return journey began with raised anxieties, heightened a couple of weeks earlier by the awful shooting down of a Malaysia Airlines aeroplane following the same route (although by then re-routed), and exacerbated when we were separated into two distinct travelling units, Jonathan with one child and Sara with the other, because the previous university travel firm booked tickets as two separate families! To make matters worse only Jonathan and Isabel’s tickets showed up and we had to wait to secure the other tickets. We were then given seats at opposite ends of the aeroplane and had to wait again for re-seating. The flight began well enough and was fairly smooth, only briefly punctuated by a somewhat antisocial ‘ramming’ of chair in front into one of our legs with particular force by someone who thought ‘turn off your electronics’ meant send texts to your friends!

However, we landed in one piece and breathed a sigh of relief, or possibly resignation, until, as in our usual practice of each taking one of the children through immigration the UKBA officer asked Jonathan rather sternly ‘where is the child’s mother?’ and when indicating where Sara was the officer proceeded to say that children have to be seen with their mother because mother’s are in general the carers of children and if present they have to be with the child. ‘Red rags and bulls’ often appear to Jonathan in unjust situations and he, as usual, took issue with this, but whilst we all got through immigration clearance more quickly, the officer insisted that his rather warped and myopic view of British law and custom was now right. Oh dear! We wondered what had happened in the seven months we had been away and whether we were entering Gormenghast!

But, back to the project itself! Our four key objectives have been met throughout the project, with varying degrees of success and changing morphologies:

1. Establish a sustainable research network promoting social sciences and interdisciplinary research at BU:

We have made contacts with individual academics, departments and universities across Southeast Asia, notably Universiti Kebangsaan Malaysia (UKM), Universiti Sains Malaysia (USM), Universiti Malaysia Sarawak (UNIMAS), Universiti Utara Malaysia, alongside contacts with Massey University in New Zealand,  Hong Kong University, The Chinese University of Hong Kong and the Myanmar Institute of Theology.

We have given names and contacts to people abroad and within BU to follow up. Research projects are being developed, publications are in train or planned for the future.

2. Develop research streams of locally specific or cross-cultural relevance:

Our research, completed with the Orang Asli as part of the Tasik Chini Research Centre, has culminated in numerous publications being submitted, developed and developing, wide dissemination across many fora, and establishing on-going research links.

3. Engage and promote educational initiatives via guest lectures/research seminars, developing joint postgraduate research supervision and educational initiatives promoting student mobility:

We have presented lectures and seminars, provided postgraduate supervision and contributed to curriculum planning and development discussions, as well as negotiated an important credit transfer scheme (although uptake has been delayed until we can find students both able and willing to go on this exciting opportunity!). Professional papers have been written and submitted.

4. Engage in discipline-specific activities in relation to social work:

a number of discipline specific activities concerning social action and development have been undertaken, including curriculum planning, assisting in education developments in Myanmar and in Malaysia in reference to the new (to be implemented) standardised Malaysian Diploma Social Work, alongside contributing to NGO development work.

Overall, during the study leave period, there has been 57 outputs, also including on-going work and connections to be completed over time. The 57 outputs included:

  • 6 books (3 published)
  • 14 book chapters (11 published or in press)
  • 12 peer reviewed papers (9 published or in press)
  • 3 professional papers
  • 1 book review
  • 16 conference presentations/open lectures etc.
  • 10 blogs
  • 6 media presentations

During our time away we have worked across five countries: Malaysia, Hong Kong SAR, Australia, Myanmar and Cambodia in order to carry out our research or present it, along with capacity-building missions for professional, social work training. We have undertaken respectively between 24 to 28 flights (trying, when one of us dislikes flying) and stayed in some extraordinarily interesting as well as very grim places during our fieldwork, resulting in abuse from miscellaneous assortments of blood-sucking insects (outsized mosquitoes, the usual bed bugs and fever-inducing leeches) bedding down with us or boisterously noisy lizards, both small and decidedly large, showering us with ordure from above.

One of us was joyfully returning ‘home’ to pioneering fieldwork in Southeast Asia and the other was equally rapturous to be introduced to it. We have developed a new appreciation of the diversity of international driving styles when finding it not unusual to be driven by taxi in the wrong direction through chaotic Yangon in the middle of two long lines of equally erratic cars heading in the right direction – towards us. Above all, we remember the various wonderfully funny, kind, clever, intriguing and endlessly good-natured people we me: all our participants, our various helpers, interpreters, drivers, guides and advisors, the academic staff and students who welcomed us so warmly, the inspiring NGO workers and service users; not forgetting the local café owner in Penang, who wept when we left before running to get her camera for group photos to remember us by.

Also, we will always remember just how much our children, Isabel and Milly grew and developed in stature (in all ways possible): learning the research process, engaging with children amongst the village communities, and themselves collecting valuable data and compiling magnificent school projects on their adventures and experiences. The children put up with a good deal with great fortitude, willingness and humour (or when the going got tough – heavy irony), easily comprehending the importance of the work undertaken; albeit, as 10 year-old Milly gravely commented in her write-up later, ‘fieldwork has its dark side’! Indeed, so impressed were we with them that they will be contributing their experiences and acting as co-authors to the forthcoming book on the Tasik Chini area.

Alongside the outputs, the work is now to capitalise on the study leave by the development and submission of funded research projects. Currently, these include gendered rituals in professional working, problematizing research ethics and learning disabilities, understanding religion as resistance, and gender in higher education.

The study leave represented a life-giving oasis, somewhere to wash and attend to our own sacred cattle as in the photo from Cambodia, and we gratefully acknowledge the help and supported afforded us by Bournemouth University and our two main host universities in Malaysia (UKM and USM). We would encourage other academic staff to apply for study leave and we think that the productivity of our period of study leave indicates how important this can be to both individual academics but also to the greater good of Bournemouth University.

Jonathan Parker & Sara Ashencaen Crabtree

Surrogate mother producing faulty goods: commodification of childbirth

Over the weekend an interesting story appeared on the BBC news and in the Sunday papers.  The story goes that an Australian couple left a Thai surrogate mother with a baby who is genetically their child.  The reason for this abandonment is that the baby is not perfect.  If that is not bad enough the couple has taken the healthy twin sister of this baby back home to Australia.  Some newspapers reported that the Australian parents knew that the baby had Down’s syndrome from the fourth month of gestation onwards, but that they did not ask until the seventh month  – through the surrogacy agency – for selective abortion of the affected fetus.    The surrogate mother, Pattaramon Chanbua, says that the couple were told: (a) that she was carrying twins and (b) that one of the twins had Down’s syndrome as well as heart problems. The surrogate mother refused the intervention on the grounds of her Buddhist beliefs.

Surrogacy is often a commercial transaction e.g. in the USA, although such a ‘business contract’ is not legal in the UK (Ireland 2011) and some parts of Australia as widely reported in the media.  However, in this case the Australian couple had paid Pattaramon Chanbua (a mother of two) to grow and carry the baby for them. She told the BBC that she had engaged in the surrogacy deal to get money to pay for the education of her other children.

This case epitomises several aspects of life that are of interest to sociology: (a) the commodification and commercialization of life (and health); (b) inequality and exploitation; and (c) globalisation.  Commodification refers to the process by which something that was not originally bought and sold becomes a good or service, i.e. a commodity that is for sale.  As we become more modern and with economic progress/the rise of capitalism, more and more parts of our lives become commodified.  Modernisation changes society and its social institutions and organisations. Economic development is based on industrialisation, but is also strongly linked to urbanisation, mass education, occupational specialisation and communication development, which in turn are linked with still broader cultural and social changes (Inglehart 1997).

The second key issue sociologists are interested in is inequality and the link between poverty and poor health.  In a global perspective where we, people in high-income countries, or so-called developed countries exploit people in low-income countries (or Third World, developing countries or under-developed countries).

Thirdly, globalisation refers to the world becoming a smaller place, both in terms of physical travel as well as the way we perceive it (Simkhada & van Teijlingen 2009).  It takes us less time to travel to London, Paris, Kathmandu than it took our parents’ or grandparents’ generation, and at the same time the information about a disaster or a  human tragedy story such as this one in Thailand reaches us more or less instantaneously.  At the same time, modernisation and globalisation, particularly in many low-income societies, are contributing to rapid socio-cultural changes.

Surrogacy as commodification

Surrogacy is the commodification of a couple having a baby themselves.  Other social solutions from the past to the problem of not being able to conceive include: (a) having more than one wife, a solution for men in a patriarchal society; (b) for women sleeping with their husband’s brother, to increase the likelihood that the baby ‘looks like’ the husband; and (c) adopting someone else’s child.

We must remember that aspects of maternity care have always been commodified.  Rich British families in the nineteenth century would have been paying a wet nurse to breastfeed their babies and a nanny to look after their children whilst instant formula baby milk bought from a shop has been replacing breastmilk supplied by the baby’s mother for nearly a century.

We don’t think surrogacy is the interesting issue here, we should ask ourselves the more basic question ‘What makes us think that every birth and every baby is going to be perfect or even okay?’

One explanation is, of course, that we have seen a rapid decline in the number and the proportion of babies dying in high-income countries such as the UK over the past century and a half.  Women having better nutrition, fewer children, having one’s first child later (but not too much later), better sanitation, and improved obstetric care have all contributed to making childbirth safer now for both mother and baby than ever before in the history of humanity.   However, these changes have also affected our ways of thinking about childbirth (Mackenzie Bryers & van Teijlingen 2010).

Social scientists recognise a social model and a medical model of childbirth (van Teijlingen 2005; van Teijlingen & Ireland 2013).  The former sees childbirth as a physiological event in women’s lives.  Pregnant women need psycho-social support, but not necessarily high-technology interventions by doctors.    The medical model stresses that childbirth can be pathological, i.e. every pregnant woman is potentially at risk.  The medical model argues that every birth needs to be in hospital with high-technology screening equipment supervised by expert obstetricians.  In other words, pregnancy and childbirth are only safe in retrospect.  In terms of social changes, we have moved from a more social model to a more medical model in a society which is more risk averse.

 

 

Edwin van Teijlingen1 & Jillian Ireland2

  1. Professor of Reproductive Health Research, Centre for Midwifery, Maternal & Perinatal Health, Bournemouth University.
  2. Visiting Faculty, Centre for Midwifery, Maternal & Perinatal Health, Bournemouth University; Midwife & Supervisor of Midwives, RCM learning Rep. Poole NHS Hospitals Trust.

 

 

References:

Inglehart R. (1997). Modernisation and post modernisation: Cultural, economic, and political change in 43 societies. New Jersey: Princeton University Press.

Ireland, J. (2011) Reflections on surrogacy-using the Taylor model to understand and manage the emotions in clinical practice, Essentially Midirs, 2(9): 17-21.

Ireland, J., van Teijlingen, E. (2013) Normal birth: social-medical model, The Practising Midwife 16(11): 17-20.

MacKenzie Bryers, H., van Teijlingen, E. (2010) Risk, Theory, Social & Medical Models: a critical analysis of the concept of risk in maternity care, Midwifery 26(5): 488-496.

Simkhada, P.P., van Teijlingen, E. (2009) Health: a global perspective, In: Alder, B. et al. (Eds.) Psychology & Sociology Applied to Medicine (3rd edn.), Edinburgh: Elsevier: 158-159.

Teijlingen van, E. (2005) A critical analysis of the medical model as used in the study of pregnancy and childbirth, Sociological Research Online, 10(2) Web address: http://www.socresonline.org.uk/10/2/teijlingen.html