Papers by Rodante van der Waal
PloS one, Apr 22, 2024
Obstetric violence is an urgent global problem. Recently, several studies have appeared on obstet... more Obstetric violence is an urgent global problem. Recently, several studies have appeared on obstetric violence in the Netherlands, indicating that it is a more widespread phenomenon in Dutch maternity care than commonly thought. At the same time, there has been very little public outrage over these studies. The objective of this qualitative research is to gain insight into the working and normalization of obstetric violence by focusing on the moral and epistemic injustices that both facilitate obstetric violence and make it look acceptable. Following the study design of Responsive Evaluation, interviews, homogenous, and heterogenous focus groups were done in three phases, with thirty-one participants, consisting of ten mothers, eleven midwives, five doulas and five midwives in training. All participants were already critically engaged with the topic, which was a selection criterion to be able to bring the existing depth of knowledge on this topic of people in the field to the fore. Data was analyzed through Thematic Analysis. We elaborate on two groups of results. First, we discuss the forms of obstetric violence most commonly mentioned by the participants, which were vaginal examinations, episiotomies, and pelvic floor support. Second, we demonstrate two major themes that concern practices related to moral and epistemic injustice: 1) 'Playing the dead baby card', with the sub-themes 'shroud waving', 'hidden agenda', and 'normalizing obstetric violence'; and 2) 'Troubling consent', with sub-themes 'not being asked for consent', 'saying "yes"', 'saying "no"', and 'giving up resistance'. While epistemic injustice has been analyzed in relation to obstetric violence, moral injustice has not yet been conceptualized as a fundamental part of both the practice and the justification of obstetric violence. This research hence contributes not only to the better understanding of obstetric violence in the Netherlands, but also to a further theorization of this specific form of gender-based violence.
Feminist theory, Apr 19, 2024
Technophany A Journal for Philosophy and Technology, Jan 21, 2024
One of the major strands of feminism concerned with reproduction, represented in this essay by Sh... more One of the major strands of feminism concerned with reproduction, represented in this essay by Shulamith Firestone, is tied to a belief in technology as the means to achieve reproductive justice. As such, this strain of feminism has difficulty formulating a critique of institutionalized reproductive technologies that have the capacity to perpetuate systemic racializing and misogynous violence. The prioritization of technology as the primary way to achieve reproductive justice can also trouble the possibility of a conception of reproductive justice where care for the body takes central stage. This is not because technology is deemed mutually exclusive with care, but because it misrepresents reproductive injustice as a biological problem that we can fix, rather than as a cultural issue. In this essay, we offer a perspective on achieving reproductive justice from a different position based in another age-old materialist doctrine, but one that is largely neglected by feminism: that of midwifery. Midwifery has always both used technology and been critical of it, having first-hand experience with its consequences in birth and pregnancy. As such, it has developed both a body of thought on the "techne" (defined as art and skill) of dealing with reproduction, and it has developed a field of scholarship critiquing the misuse of technology. While midwifery is not wary of technology, it negotiates technology from a materialist position that prioritizes experiential, embodied, and tacit knowledge, as well as the physiological process of childbirth, which it aims to facilitate and enhance. Midwifery's epistemological standpoint can hence be characterized as a somatophillic techne that aims to think with the body, rather than fix it. There is, however, a certain tendency in midwifery which is developing towards an anti-technological essentialism. This essay aims to redirect this tendency to the more promising materialist doctrine that can be found in midwifery as well as Firestonian feminism, but develops this materialist stance through a specific "somatophillic techne" embedded in "relational midwifery thinking."
Agenda (Durban), Jul 3, 2021
Rachelle Chadwick has been a crucial voice in theorising and exploring obstetric violence in the ... more Rachelle Chadwick has been a crucial voice in theorising and exploring obstetric violence in the global south, especially in South Africa. Chadwick has published widely on reproductive politics, bi...
Violence Against Women, Dec 5, 2023
Gender-Based Violence: A Comprehensive Guide
Tijdschrift voor Genderstudies
International Confederation of Midwives (ICM) Newsletter, 2022
In de gezondheidszorg en ethiek rondom zwangerschap en geboorte is de aandacht vaak gefocust op h... more In de gezondheidszorg en ethiek rondom zwangerschap en geboorte is de aandacht vaak gefocust op het kind: het kind dat gewenst wordt, het kind dat in de baarmoeder groeit en zo gezond mogelijk ter wereld dient te komen, het kind dat mogelijk een beperking heeft, of dat een erfelijk risico loopt. Deze kwesties krijgen terecht aandacht in de zorg; de inspanningen van de meeste wens- of aanstaande ouders en de zorgprofessionals zijn gericht op een gezond kind met een goede start. Minder aandacht krijgen echter de ethische en existentiële kwesties die te maken hebben met de moeder, haar beleving, haar transitie naar moederschap.
Feminist Anthropology
Obstetric violence, a term coined by activists in Latin America to describe violence during pregn... more Obstetric violence, a term coined by activists in Latin America to describe violence during pregnancy, childbirth, and postpartum, is a controversial feminist term in global health policymaking as well as in obstetric and midwifery practice and research. We reflect on the term both theoretically and autoethnographically to demonstrate its feminist value in addressing the problem of violence as embedded within the obstetric institution. We argue that obstetric violence as an activist and critical feminist concept can only be effective for change when it is clearly understood as institutionalized intersectional violence. Therefore, we propose an abolitionist framework for further study. Through this lens, we refract the concept of obstetric violence as institutionalized, intersectional, and racializing violence by (1) making an abolitionist historiography of the obstetric institution, and (2) centering anti-Black obstetric racism as the anchor point of obstetric violence, where the afterlife of slavery, racial capitalism, the impact of systemic racism, and the consequences of patriarchal biopolitics come together. Abolition provides a unique approach to study obstetric violence since it not only refuses and dismantles violent institutions, but specifically focuses on building futures out of existing alternative practices toward a life-affirming world of care. We locate the abolitionist futures of maternity care in Black, Indigenous, and independent doula and midwifery practices.
Agenda, 2021
Building on the work of Mbembe (2019) and Silva (2007), we theorise how the obstetric institution... more Building on the work of Mbembe (2019) and Silva (2007), we theorise how the obstetric institution can still be considered fundamentally modern, that is, entangled with colonialism, slavery, bio- and necropolitics and patriarchal subjectivity. We argue that the modern obstetric subject (doctor or midwife) representing the obstetric institution engulfs the (m)other in a typically modern way as othered, racialised, affectable and outer-determined, in order to constitute itself in terms of self-determination and universal reason. While Davis-Floyd (1987) described obstetric training as a rite of passage into a technocratic model of childbirth, we argue that students’ rite of passage is not merely an initiation into a technological model of childbirth. The many instances of obstetric violence and racism in their training make a more fundamental problem visible, namely that students come of age within obstetrics through the violent appropriation of the (m)other. We amplify students’ curricular encounters in two colonially related geopolitical spaces, South Africa and the Netherlands, and in two professions, obstetric medicine and midwifery, to highlight global systemic tendencies that push students to cross ethical, social and political boundaries towards the (m)other they are trained to care for. The embedment of obstetric violence in their rite of passage ensures the reproduction of the modern obstetric subject, the racialised (m)other, and institutionalised violence worldwide.
Agenda, 2021
Rachelle Chadwick has been a crucial voice in theorising and exploring obstetric violence in the ... more Rachelle Chadwick has been a crucial voice in theorising and exploring obstetric violence in the global south, especially in South Africa. Chadwick has published widely on reproductive politics, bi...
Nursing Ethics
Nursing Ethics has published several pleas for care ethics and/or relationality as the most promi... more Nursing Ethics has published several pleas for care ethics and/or relationality as the most promising ethical foundation for midwifery philosophy and practice. In this article, we stand by these calls, contributing to them with the identification of the structural form of violence that a care ethical relational approach to reproductive care is up against: that of “maternal separation”. Confronted with reproductive and obstetric violence globally, we show that a hegemonic racialized, instrumentalized, and individualized conception of pregnancy is responsible for a severance of relationalities that are essential to safe reproductive care: (1) the relation between the person and their child or reproductive capabilities; and (2) the relation between the pregnant person and their community of care. We pinpoint a separation of the maternal relation in at least two discursive domains, namely, the juridical-political and the ethical-existential. Consequently, we plea for a radical re-imagin...
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Papers by Rodante van der Waal