Being a midwife in West Africa: Between sensory experiences, moral standards, socio-technical violence and affective constraints

Yannick Jaffré and Isabelle L. Lange

Social Science & Medicine, 2021, vol. 276, issue C

Abstract: Despite a long history of maternal health programs, the quality of obstetric care and access to facility services remain inadequate in West Africa. Although several qualitative studies have described human resource and facility constraints impacting pregnancy care and the violent or disrespectful care of women during labor, the reasons behind these behaviors have not been elucidated. In order to understand midwives' experiences with caregiving, in 2017–2018 we conducted interviews with 24 professional midwives in Benin and Burkina Faso and examined their perspectives on their profession, obstetric practices and personal lives. By including emotional, sensorial, linguistic and social elements, this paper shows important discordances between the proposals made by programs (such as rural postings and financial disbursement projects) and midwives' socio-emotional duties and economic roles. The study also shows that midwives' attitudes towards their patients are linked to their considering childbirth to be a moral act. Midwives’ mistreatment of women in labor corresponds to constant shifts between technical obstetric skills and value judgements concerning expressions of pain, sexuality and desire. In addition, midwives justify their violent practices through the urgency of the situation, especially during crowning.

Keywords: Benin; Burkina Faso; Midwifery; Midwives; Quality of care; Program implementation; Gender; Disrespect & abuse; Reasons for acting (search for similar items in EconPapers)
Date: 2021
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DOI: 10.1016/j.socscimed.2021.113842

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