3.5.2 Toni Delany
1 like354 views
The research explores how maternal responsibility for child health is constructed and reinforced through public health and medical discourse, emphasizing that women are often blamed for reproductive health outcomes. By analyzing interviews with mothers and medical professionals, the study highlights the absence of male involvement and the perception of women as primarily responsible for child well-being. The findings suggest the necessity for broader approaches in health education that include men and contextual factors affecting reproductive health.
![Genetic counsellor :
We’ve talked about women expressing feelings of
responsibility or guilt, do you find that similarly with
men?
I probably haven’t had anywhere near the number of
conversations with men. And I mean there's virtually
nothing that can affect sperm ... we don’t know of
anything really that affects sperm [...] that can then
affect a conception. So uh I don’t think it is anywhere
near the same issue for men as it is for women...](https://image.slidesharecdn.com/3-150313191705-conversion-gate01/85/3-5-2-Toni-Delany-10-320.jpg)
![Obstetrician:
Women do feel responsible; they do feel guilt, um ... Because
they are responsible. I mean they created this child. And so
some might have a pathological feeling [of guilt] to that
matter which then would need to be handled. But uh ... I think
that extends to other things in life too. If you have a car
accident you wish you were driving 5 kilometres per hour
slower, or weren’t driving at all or you walked, that’s life.](https://image.slidesharecdn.com/3-150313191705-conversion-gate01/85/3-5-2-Toni-Delany-13-320.jpg)
3.5.2 Toni Delany
- 1. How is maternal responsibility constructed and perpetuated through health discourse? Toni Delany GWSI & Public Health LIGHt Group
- 2. Arguments • Medical and public health practice reinforces women’s greater responsibility for child health • Reproductive health is understood as influenced mainly by the behaviours and biology of women. This may lead to blaming and guilt for women
- 3. Aims of research • To explore how maternal responsibility for child health is constructed and perpetuated through public health and medicine • To examine the concept of maternal responsibility to highlight its construction and implications
- 4. Overview of project MATERNAL RESPONSIBILITY Lens: Congenital health problems Medical Literature Health Education Materials Interviews • Mothers • Medical Professionals
- 5. Discourse • The ways we talk about and represent women and reproduction • Creates and reinforces dominant understandings. Therefore, discourses are also expressions of power • Discourse analysis examines how language and practices construct social phenomena and produce social realities
- 6. Semi-structured interviews • 28 women who mother children with: spina bifida, congenital heart disease and naevus (a dermatological condition) • 7 medical professionals: obstetricians, neonatologists, paediatricians, geneticists and genetic counsellors
- 7. Health education materials and medical literature • 21 health education materials (e.g. pamphlets) • 10 chapters from medical textbooks • 15 journal articles
- 8. Male exclusion • Lack of reproductive health advice targeted at men • No health education materials routinely provided to men • Male smokers receive some advice (although not routinely) • Most advice for men is linked to fertility not to child health
- 9. Kath* : Nothing. He would’ve got nothing. Oh no hang on….undies (laughs). I remember something to do with the undies or the boxers you know, that thing, that was the only thing I've ever heard to do with yeah the whole pregnancy thing. So do you think that he was expected to be involved in helping you to keep yourself healthy during pregnancy? No. No. I don’t think so. And I felt like it was just my job to do sort of thing and I guess he just felt the same. Why did you think of was your job? Um … just because it's me … I don’t know … me looking after the little thing I guess. (3 year old son with congenital heart disease) *Pseudonyms used throughout presentation
- 10. Genetic counsellor : We’ve talked about women expressing feelings of responsibility or guilt, do you find that similarly with men? I probably haven’t had anywhere near the number of conversations with men. And I mean there's virtually nothing that can affect sperm ... we don’t know of anything really that affects sperm [...] that can then affect a conception. So uh I don’t think it is anywhere near the same issue for men as it is for women...
- 11. ‘Safe’ sperm? Correlation between sperm damage and: * cigarette smoking (Yauk et al., 2007; Zenzes et al.,1999) * air pollution (Rubes et al., 2009) * occupational exposures (Hsu et al., 2006)
- 12. Absence of the social • Limited consideration of broader social, relational and environmental influences within mainstream discourse • Renders reproductive health as dependent on ‘correct’ ‘choices’ • Provides potential for individualised blame Health is a choice Learn how to choose it
- 13. Obstetrician: Women do feel responsible; they do feel guilt, um ... Because they are responsible. I mean they created this child. And so some might have a pathological feeling [of guilt] to that matter which then would need to be handled. But uh ... I think that extends to other things in life too. If you have a car accident you wish you were driving 5 kilometres per hour slower, or weren’t driving at all or you walked, that’s life.
- 14. In the absence of a conceptual framework which extends beyond the individual, guilt is deflected ‘from an externalized to an internalized moral discourse’ (Comaroff, 1982:56) Illness is thus experienced as a private trouble (Edwards, 1994:2)
- 15. Intensive mothering • A dominant social ideology • Aligns ‘good’ mothering with unlimited expression of resources and personal sacrifice by women • Exposure to mainstream health discourse encourages intensive mothering • Interview participants engaged in intensive mothering to represent themselves as ‘good’, credible mothers
- 16. Key points • The absence of men and the social context reinforces women’s greater responsibility beyond their biological functions • These discourses perpetuate gendered stereotypes and reinforce the relative distance of men from children and reproduction
- 17. Practical strategies • Routinely provide reproductive health education resources to men • Broaden research focus • Make clear that individual behaviour change is not effective in all cases
- 18. Acknowledgements Associate Professor Margie Ripper Associate Professor Vivienne Moore Dr Megan Warin LIGHt research group Interview participants
- 19. Toni Delany PhD Candidate [email protected] Disciplines of Gender, Work & Social Inquiry and Public Health LIGHt Research Group University of Adelaide
Editor's Notes
- #2: <number>
- #3: <number>
- #4: <number>
- #5: <number> As you can see in this diagram, the main focus of the research is on the concept of maternal responsibility. However, in order to adequately explore this broad concept I have applied a lens through which I'm viewing it. That lens is congenital health problems. Just in case it isn't clear what I mean by congenital health problems- I’m using the term loosely to any medical condition that is present from birth which produces some degree of disability and/or illness. So this excludes health problems that develop after an infant is born. Congenital health problems can be diagnosed during pregnancy or after birth. Other terms that can be used to refer to such health problems are birth defects and congenital abnormalities. So back to the overview- While my immediate focus is on exploring the discourses that permeate thinking about the causes and prevention of congenital health problems- I aim to link my findings back to a broader analysis of the construction and implications of dominant understandings about maternal responsibility for child health in Australian society. In order to consider how maternal responsibility becomes constructed in relation to children’s health, I am examining some of the health related discourses that women are likely to be exposed to, and targeted by, during their reproductive years, and especially, during pregnancy. As you can see on the diagram, the discourses that I’m focussing on are those that are present within medical literature, health education materials and women’s own accounts of their experiences of having a child with health problems. The medical literature that I’m examining consists of medical textbooks and journal articles- but I’ll explain more about those sources in a few minutes. The health education materials consist of information booklets and pamphlets that are routinely provided to women. These materials are usually provided at women’s first antenatal appointment that they have with either their midwife or obstetrician during their early pregnancy. I had intended to also analyse the information pamphlets that are routinely provided to men about conception of pregnancy- however, I have found that there actually aren't any- instead all the routinely distributed information is targeted at women- which in itself indicates something about maternal responsibility! I have a few examples of health education materials here. I can pass them around if anyone is interested in having a look. I will analyse the health education materials that I’ve collected using an initial content analysis followed by a critical discourse analysis. In the interviewing component of the project I am speaking with women who have children with congenital health problems aged five years and under. The interviews are semi structured and cover issues such as the women’s feelings about the origins of their children’s conditions, their experiences of having contact with the medical profession and also their recollections about the kinds of health information that they and their partner received before and during pregnancy. I’m interviewing women who have children with the conditions Spina Bifida, congenital heart disease, Foetal alcohol syndrome and the dermatological condition Nevus. People often ask me what Nevus is, so I’ll tell you that
- #6: <number>
- #7: <number>
- #8: <number>
- #9: <number>
- #10: <number>
- #11: <number>
- #12: <number>
- #13: <number>
- #14: <number>
- #15: <number>
- #16: <number>
- #17: <number>
- #18: <number>
- #19: <number>
- #20: <number>