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International team analyzes the history of medicalization of birth in China and Japan in the 20th and 21st centuries

The history of medicalization of birth in China and Japan is the subject of a special section of Technology and Culture, the official magazine of the Society for the History of Technology, in the United States of America, and one of the most renowned magazines in the field of social studies of science and technology, which has just been published.

Gonçalo Santos, professor at the Department of Life Sciences at the Faculty of Sciences and Technology of the University of Coimbra (FCTUC) and an integrated researcher at the Center for Research Network in Anthropology (CRIA), University of Coimbra, is one of the coordinators of this special section, where the social and moral tensions caused by the medicalization process of birth in these two East Asian countries are analyzed. It includes articles written by anthropologists and historians and is an important interdisciplinary contribution to the critical analysis of processes of the medicalization of birth in East Asia and worldwide.

With the institutional growth of scientific medicine, birth moved from the domestic space to the hospital and began to be approached as a dangerous event that requires obstetric intervention to minimize risks and save lives. This medicalization process was intensified throughout the 20th century, culminating in the normalization of a model of birth assistance that imposes on women the need to structure childbirth according to a cascade of obstetric interventions.

«In China and Japan, as in Europe and the United States, this transformation has been accompanied by growing moral tensions between supporters of the dominant technocratic model and supporters of a more humanized model of birth, but there are few studies on the contours of these ‘wars of childbirth ‘. This special section takes a first small step in that direction”, says Gonçalo Santos.

In both Japan and China today, birth care is largely dominated by technocratic values, especially in China, where the rate of cesarean sections is among the highest in the world, “well above the 10-15% recommended by the World Health Organization. Health. In both societies, the medicalization of birth generated a very powerful technocratic value system that was not contested as in Europe and the United States by radical social movements questioning the logic of medicalization and advocating a return to more “natural” and without any kind of medical intervention, says Gonçalo Santos.

There are social movements in China and Japan that advocate a more humanized model of birth and that value the more natural approaches to traditional medicines, but these movements do not reject the authority of doctors and hospitals. “This results in a kind of double moral bond that places irreconcilable demands on women: on the one hand, it is necessary to accept giving birth in the hospital with constant medical interventions; on the other hand, it is necessary to cultivate a “natural body” and try to avoid unnecessary medical interventions without jeopardizing the baby’s well-being. This special section shows the historical genesis and the ethnographic contours of this double moral bond in the contemporary period“, he notes.

The article on China by the FCTUC professor focuses on the exponential growth of cesarean rates in rural areas since the turn of the millennium, illustrating this transformation with ethnographic materials collected over two decades of fieldwork visits to a rural community in southern China.

The author compares the birth experiences of two different generations of women, showing that these different generational experiences have resulted in radically different views of the meaning and moral value of the growing popularity of cesarean sections.

China is a perfect example of compressed reproductive modernity, that is, it is an emerging economy that has gone from a low-tech system of birth to a high-tech system in the space of a generation. This process of “technological leapfrogging” has generated many generational tensions and it is important to understand the role of these tensions in family negotiation processes that help to shape women’s preferences and birth experiences”, says Gonçalo Santos.

The relevance of the experiences of women in this small rural community goes far beyond the rural areas of China or China itself as a whole. Women from other countries in East Asia and elsewhere in the world “are also being confronted with an unprecedented dynamic of medicalization. An important contribution of the articles in this special section is to draw attention to the importance of the women’s own point of view on the dynamics of medicalization and technologization underway. In short, we intend to draw attention to the importance of developing public health policies that take into account the point of view of women”, he concludes.

This publication was supported by the Research Grants Council of Hong Kong, the University of Hong Kong and the Smith College (East Asian Studies Fund) and is an initiative of an international research group on reproductive technologies in East Asia, led by Gonçalo Santos, by Jacob Eyferth (University of Chicago) and Suzanne Gottschang (Smith College). To carry out this project, the FCTUC professor, who currently coordinates the international Sci-Tech Asia network, benefited from a Visiting Scholar Fellowship awarded by the Max Planck Institute for the History of Science, in Berlin, in 2018/2019.

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