Emotional labour as a vehicle of organisational change in maternity care: The case of Russian doulas' institutional work

Abstract

Sociological scholars of healthcare professions are becoming increasingly aware of the organisational dimension of professionalism, including how professionals as institutional actors are exposed to and influence organisational transformation. By tracing the ground‐level professional efforts of Russian doulas—a caring profession that has been plunged into a reforming health system—in this article I explore how meaning‐making activities and professionals' emotional labour build into and advance institutional changes in post‐socialist maternity care. Drawing on qualitative research materials, I define three ways through which doulas' institutional efforts engage with emotions in clinical settings: (1) redefining emotional labour as a compound of maternity care; (2) grounding emotional labour in the context of reforming institutions; (3) using emotional labour to bridge discrepancies within organisational arrangements in healthcare. My research findings provide new insights into how marketisation influences professional care, as well as about caring professionalism in post‐socialist maternity care. Attention to doulas' professional efforts allows for the affective transformation and inequality in the context of healthcare reforms to be analytically grasped. In particular, I trace how doulas' institutional agency embodied in emotional labour constructs the neo‐liberal patient's identity.

The impacts of the COVID-19 pandemic on birth satisfaction and birth experiences in Russian women

“…However, despite the persistence of these conservative soviet practices, gradually many healthcare providers choose modern evidence-based approaches ( 38 ) and follow the WHO guidelines for intrapartum care ( 13 ). This trend is also reflected in the new recommendations for obstetric and gynaecology care of the Ministry of Health of the Russian Federation ( 39 ).…”

“…This trend is also reflected in the new recommendations for obstetric and gynaecology care of the Ministry of Health of the Russian Federation ( 39 ). There is evidence that in the past ten years more women have been choosing to give birth with at least one support person present at labour and birth, birth partners have been more involved, and doula services have become more popular, with an official Association for professional doulas established in 2015 ( 38 , 40 ). However, many of these trends were interrupted by the COVID-19 related measures and the maternity healthcare system returned to more familiar conservative practices ( 33 ).…”