It also examines how individual agency or repression is reflected in this complex interplay. By utilising the theory of embodiment to interpret the medicalisation of childbirth, I highlight the importance of recognising women as active agents in their birthing processes and promoting individualised, culturally sensitive, and empowering approaches.
Medicalisation of society, managed childbirth experience
In the Gannan Tibetan Autonomous Prefecture, the Tibetan, Han, and Hui ethnic groups preserve their respective marriage and childbirth customs and gender norms. The area, characterised by the shift from traditional to modern practices, provides an excellent opportunity to examine the cis-female body within the framework of medical modernisation.
In The Medicalization of Society, Peter Conrad stated that over the past half-century, the social terrain of health and illness has been transformed. What were once considered normal human events and common human events are now viewed as medical conditions. For better or worse, medicine increasingly permeates aspects of daily life. Just as Madeleine Akrich and Bernike Pasveer asked, how do women experience childbirth today? What role does the body, their body, occupy in the way they describe it? And to what extent may technology and medical practices be considered as determining the shaping of this experience and the positioning of the body within it?
Recent scholars have directed their attention towards the embodied experiences of women, investigating the complex power relations that intersect with the female body. Scholars such as Gena Corea have concentrated on the effects of medicalised reproductive technologies on women's embodied experiences, illuminating the tension between the technical aspects of medicine and the corporeal experience. Other scholars, such as Emily Martin, have examined the impact of medicalised reproductive technologies on the construction of motherhood, focusing on the social dimensions of gendered body. Although issues surrounding the medicalisation of childbirth have been widely documented, the personal stories of cis-women have largely gone unnoticed.
The concept of "embodiment" helps to bridge many dichotomies, such as the relationship between the self and society, and action and structure. It emphasises not only the role of the body itself in human cognition and action but also the multiple attributes and abilities of the embodied agent. Through my fieldwork in Gannan, I grappled with the embodied practices of local women during childbirth. The theory of embodiment acknowledges that individuals possess agency and the ability to act upon their bodies. However, power dynamics within sociocultural and medical contexts can influence the extent of women's agency during childbirth. My fieldwork incorporates intersectionality into the theory of embodiment, analysing disparities and inequities in access to and experiences of childbirth.
Distinct orientations of embodied practice
This study analysed 37 cases from Gannan and identified three distinct categories of embodied practice during childbirth: memory-oriented,’ daily-life and family relation-oriented, and medical technology-oriented. These practices reflect how local women experience their bodies in relation to ethnic traditions, social contexts, and medical settings during childbirth. During my fieldwork, regrettably, I did not come across any self-identifying transgender women during my interviews with the locals.
The memory-oriented perspective demonstrate how older women narrate their reproductive experiences and practices in the present. The phenomenon of home birth has long been entrenched in local traditions and forms a significant aspect of the collective memories of elder women. However, this method has become increasingly uncommon. As a result, the present study endeavours to retrospectively explore the corporeal memories of women, in order to comprehend the role and the ‘pre-medical’ context within their lived experiences.
For instance, Aunt Zhang is a fifty-something Tibetan woman and mother of three daughters, who has predominantly resided in pastoral regions. At the tender age of sixteen, she acquiesced to an arranged marriage with a local painter, complying with her parents' arrangement. Aunt Zhang delivered her three daughters in the confines of her own abode, without the presence of a dedicated midwife or her spouse. Following childbirth, should the demands of her daily responsibilities prove overwhelming, she endeavoured to curtail her period of rest. Testimonies from other elderly Tibetan women corroborated this pattern, with some recounting how they would arise early on the day following delivery to fetch three buckets of water from the river, emphasising their ability to persist in their laborious tasks post-childbirth. Within their memories, the act of giving birth assumed a quotidian, innate, and inevitable character. For these women, childbirth necessitated harmonisation with the demands of daily life and labour.
The daily-life and family relation-oriented practice shows how women integrate the medical space into their daily lives. With the scene shifting from home births to hospital settings, women assume multiple gender roles. Consequently, the birthing process becomes a convergence of medical and social spaces within women's experiences. This convergence offers a unique opportunity for women to express suppressed emotions and navigate the complexities of their everyday lives and social relationships. Through childbirth, women integrate societal and familial dynamics, navigating the interplay between societal expectations, their actual and ideal roles, and the conflicts that arise from self-identity and societal motherhood expectations.
The medical technology-oriented orientation highlights women's compliance with medical technology when it overlaps with sociocultural expectations. Motherhood compels them to carefully consider the balance between natural embodied experiences, and the dominance of medical discourse. Building upon this premise, women interpret and rationalise their identities through the use of technological means and the cultural connotations. For instance, Ah Cao, an unmarried Tibetan girl, chose to undergo a caesarean section despite having the option of natural childbirth. She does not regret her decision, as she believes it not only mitigated risks but also constituted a way to "take better care of herself." Ah Cao's choice of a specific mode of reproduction places the act of childbirth at the crossroads of ethical traditions, medical discourse, and social expectations. This illustrates that what may seem like a purely technological aspect of reproductive decision-making is, in fact, socially constructed.
How to narrate the feminine body in the Tibetan region?
Iris Young discusses the alienation of female experiences during the medicalised process of pregnancy and childbirth. She points out that in the context of medicalised reproduction, women's embodied experiences are subjected to the gaze of technology. Young's exploration delves into the intricacies of feminine and masculine norms of movement through the lens of a gendered and embodied phenomenological perspective. Notably, her examination is rooted in a Eurocentric paradigm, which accentuates the existing disparities between Western and non-Western viewpoints. It is challenging to determine whether women perceive the medicalisation of childbirth as positive or negative in contemporary Tibetan regions, because the empowerment and alienation of the female body are two sides of the same coin.
When discussing the impact of modernity and medicalisation on individual experiences, it is important to delve into their lives and narratives. These stories are socially constructed within social contexts by individuals who embody the thoughts and emotions of everyday life. Each individual story has diverse and intertwined elements that shape women's unique childbirth experiences and embodied practices. Therefore, these three angles of embodied practices do not fully cover all aspects of local women's childbirth experiences and practices but rather showcase their diversity, complexity, and ambivalence. The dynamic relationship between embodiment theory and the medicalisation of childbirth sheds light on the intricate factors shaping women's childbirth experiences, including their bodies, social environments, and medical practices.