Haunting Expectations of Hospital Births Challenged by Traditional Midwives

ABSTRACT

In Balochistan, Pakistan, hospitals are not the desired location for childbirth, but an affective economy of obstetric care, deceit, and clinical tactics of control has emerged, redirecting women away from midwives toward biomedical obstetrics. This economy manifests in forms such as coercing expectant mothers to deliver in the clinic rather than the home by generating fear in them and their kin through a narrative of imminent maternal and child harm. Drawing from ethnographic research, I show why Baloch midwives’ ethical expertise and affective responses to iatrogenically induced emergencies haunt the postcolonial state and constrain biomedicine’s haunting expectations of hospital/clinical births.

KEYWORDS:

• Balochistan
• affect
• colonial haunting
• hospital
• midwives
• uterotonic injections

Acknowledgments

This article is dedicated to my mother Hasineh Towghi. I thank my interlocutors in Panjgur and elsewhere in Balochistan and Pakistan for the generosity of their time. I am grateful to Saiba Varma and Emma Varely for their deep engagement, intellectual support, and commitment to this project. I also thank Lenore Manderson, Victoria Team, and the four anonymous reviewers for helping me to improve this article. Earlier iterations of the article benefited from the participants in the “Care in Asia—Beyond and Across the Clinic” workshop, organized by Emilija Zabiliute at Nordic Institute of Asian Studies, University of Copenhagen in 2017.

Notes

^1. All names have been anonymized.

^2. Manual Vacuum Aspiration (MVA) is available in only selected Pakistani hospitals. About 37% of women who access mid-level practitioners (MLPs) such as LHVs for abortion develop complications from the common hospital D&C procedure. These MLPs are not skilled nor well trained in the use of misoprostol, MVA, and Electrical Vacuum Aspiration (EVA) (Sathar et al. 2013).

Additional information

Funding

This research was funded by the University of California Regents, American Association of University Women, and the Woodrow Wilson and Johnson and Johnson Women’s Health Fellowship.

Notes on contributors

Fouzieyha Towghi

Fouzieyha Towghi is a lecturer of Medical Anthropology in the School of Archaeology and Anthropology, Australian National University. Her scholarship focuses on the politics of reproduction, medicine, science and biotechnologies and their implication on women’s corporeal and social bodies in South Asia. She is currently writing her ethnography, Caring “In the Times of the Ladies”: Contesting Humanitarian Imaginaries of Women’s Health, Midwives, and the Tribal in Rural Balochistan.