Empowered or patronized? The role of emotions in policies and professional discourses on birth care

Abstract

While the focus on emotions has been associated with the rise of psychosocial welfare and has promised a gateway to accommodate individually diversified needs of citizens in policies, the article shows that the role of emotions needs to be better understood. Highlighting emotions can serve both to empower and to patronize those who experience them. Referring to emotions can thus strengthen hierarchies and downplay individual requests to initiate a change. The analysis of professional discourses on birth care in Czechia shows the value of contextualising emotions. While midwifery discourses apply the emotional context of birth to support women in their specific birth choices, medical discourses use the emotional context to patronize them and to limit their requirements. As a result, policy demands are seen as illegitimate when coming from midwives, who want to see women’s choices more respected in care. We analyse this dynamic through intimacy. As a conceptual framework used in sociology of care, ‘intimacy’ ties individual emotional experiences to collective discourses on care, the body and related feelings. Viewing professional discourses on birth care through intimacy reveals the role of emotions in the collective recognition of the personal struggle for the right to give birth in conditions that respect bodily and emotional integrity, which informs how we think of the role of emotions in policies in general.

Navigating the role of emotions in expertise: public framing of expertise in the Czech public controversy on birth care

“…Yet from the side of the medicalized birth group these requirements are embedded in the context of a selfish mother who wants to enjoy her birth instead of complying with her role of serving the child's best interests. The home birth group counter this by highlighting emotional circumstances as contributing to birthing safety, which makes women the expert of their own birthing (See also Durnová et al 2022). But since that framing of emotions is represented by midwives, patient advocates, and women-that is, by those who do not comply with the common understanding of a medical expert-they are not given the same amount of space in the media.…”

“…The Czech debate on the status of midwife-assisted planned homebirth in the birth care policy of the country cannot be viewed solely in the context of the well-known professional territorialism between doctors and midwives, as it raises larger questions about how the expertise around birth is established and what is seen as relevant knowledge and a legitimate argument (see also Durnová et al 2022). On the regulatory level, Czech obstetric and perinatal health care is covered by health insurance and is provided only by maternity hospitals.…”

The politics of anger: emotional appraisal mechanisms and the French pension reform protests

“…There is no dominant approach to emotion in policy studies, yet. We find studies that situate the analysis of emotions within established theories of the policy process (for example, Pierce et al, 2022), interpretive analyses that are methodologically often tied to discourse analysis (Verhoeven and Metze, 2022;Durnová et al, 2022), and recent studies that aim to bring together both 'mainstream' and interpretivist epistemologies (for example, Yordy et al, 2023).…”

Navigating vaccine hesitancy: Strategies and dynamics in healthcare professional-parent communication

“…Communication between health professionals and parents also seems to be affected by the persistence of a paternalistic approach in the Czech healthcare system. 21 …”