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Maternal Health & WellBeing

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We are at a historic moment in relation to changing practices within families; couples are most often attempting to share the care of their infants and children. These brave new families are required to bridge gaps between the so-called traditional and this 'post-traditional' eras and tensions between equity and care led Kathryn Abrams to characterize this juncture as 'the second coming of care'*. We need to find new ways to think about and quantify the work of care; linking up everyday practices within families with a reconceptualization of care at an institutional level. What appears to be a return to 'traditional gender scripts' can be more accurately depicted as new ways of doing things, a revaluing of care. In the context of these changes becoming a mother is often a profound & life-changing experience.

Issues related to identity often surface for women as new mothers.

The birth of an infant raises issues to do with the social structuring of care. Cultural traditions & beliefs about what it means to be a mother are in flux and are played out through the sense of self. Central to this mix is the interpersonal dynamics between the mother and her infant.

There is a serious lack of research and services in the postnatal phase of pregnancy and birth, particularly as this relates to the woman-as-mother. The standard for midwifery and obstetric practice in Australia concludes six weeks after the birth while there is evidence of high levels of depression, high levels of marital dissatisfaction and issues related to identity for women-as-mothers. The related health services through maternal and child health nurses are often focused on infant health and the related physical recovery of the mother.

It is clear that the medicalization of ante- and post-natal services has resulted in an emphasis on the physical aspects of pregnancy, birth and mothering to the exclusion of the social and/or psychic dimension. The current trend is towards population management with an emphasis on parenting, healthy eating and anti-smoking. It is clear that there is a medicalization and privatization of care through the family, which is individualized through gendered roles and responsibilities.

This individualized and privatized emphasis informs policy and practice. It is a governance that is carried forth through beliefs which often translate into an understanding that women-as-mothers need to become selfless. These trends are indicative of a nexus between knowledge and a working through of power whereby the sense of self is projected into the future through aspirations for the infant/child. The work on intersubjectivity from within psychoanalysis provides a means for explaining a convergence between self and other through omnipotent dynamics that advance the interests of the woman-as-mother through the associated role.

The work of care in itself is not an ethical endeavour but is facilitated by the social and cultural context; practices and meanings. While the outcome provides the conditions for an ethical base in the infant/child, the dynamics necessarily take place within the context of biological, historical, structural and psychological constructs that perpetuate gendered understandings. The current challenge is to formulate a sociological perspective on the dynamics while mindful of a collective response to a public ethics of care.

* Abrams, K., 2001. The Second Coming of Care. Chicago-Kent Law Review, 76 (3).

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