Abstract
In the US, birth has become a carefully planned experience for those with the greatest access to resources. Pregnancy preparations, including prenatal care, childbirth education, and peer interactions, encourage women to act as informed consumers, to communicate their own values, beliefs, and preferences in labor and delivery, and to challenge healthcare systems and medical providers. Simultaneously, there has been a growth in the number of mothers who reject medical recommendations for infant vaccination and newborn interventions. These challenges are presented by women with higher levels of education and resources, a group that is also most likely to insist on control over birth. In this article, I draw on qualitative data from mothers who reject vaccination recommendations for their children to highlight the interconnected experiences of childbirth self-advocacy and vaccine refusal. I suggest prenatal education toward self-advocacy may serve as a pedagogical process that mirrors the rhetoric of vaccine refusal. I conclude by showing how this new pedagogy of patient empowerment is nurtured and respected by pediatricians who administer vaccines and provide wellness care, even as they struggle with mothers who reject this core public health intervention.
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Notes
“Architected,” a noun that was transformed into a verb by some in the technology industry, was popularized and widely mocked after Ivanka Trump used it frequently in her book, Women Who Work, where she insists, “All women benefit immeasurably by architecting their lives.” For a discussion, see Tolentino (2017).
William Sears is author of dozens of books and parenting advice columns that support dominant views of vaccines, birth, and infant care. He is quite different in approach from his son, Robert “Bob” Sears, who promotes alternative vaccines schedules and whose medical license has been placed on probation after writing letters to provide medical exemption from vaccine requirements without adequate medical history or examination.
References
Afshar, Yalda, Jenny Mei, Melissa Wong, Kimberly Gregory, Sarah Kilpatrick, and Tania Esakoff. 2015. 566: The role of the birth plan in obstetrical and neonatal outcomes and birth experience satisfaction. American Journal of Obstetrics and Gynecology 212 (1): S282.
American Pregnancy Association. 2015. Creating Your Birth Plan. http://americanpregnancy.org/labor-and-birth/birth-plan/. Accessed August 2015.
Anderson, Monica. 2017. Digital divide persists even as lower-income Americans make gains in tech adoption. Washington, DC: Pew Research Center.
Apple, Rima. 2006. Perfect Motherhood: Science and Childrearing in America. New Brunswick: Rutgers University Press.
Aston, Megan L. 2002. Learning to be a normal mother: Empowerment and pedagogy in postpartum classes. Public Health Nursing 19 (4): 284–293.
Blum, Linda. 1999. At the breast: Ideologies of breastfeeding and motherhood in the contemporary United States. Boston: Beacon.
Bobel, Chris. 2002. The paradox of natural mothering. Philadelphia: Temple University Press.
Bowen, Sarah, Joslyn Brenton, and Sinikka Elliott. 2019. Pressure cooker: Why home cooking won’t solve our problems and what we can do about it. Oxford: Oxford University Press.
Brubaker, Sarah Jane, and Heather E. Dillaway. 2009. Medicalization, natural childbirth and birthing experiences. Sociology Compass 3 (1): 31–48.
Burke, Naomi, Jennifer C. Donnelly, Gerry Burke, Fionnuala Breathnach, Fionnuala McAuliffe, John Morrison, Michael Turner, Samina Dornan, John Higgins, and Amanda Cotter. 2016. 507: Do birth plans improve obstetric outcome for first time mothers: results from the multi-center Genesis Study. American Journal of Obstetrics and Gynecology 214 (1): S276.
CDPHE. 2015. Colorado Kindergarten Immunization Survey (2013–2014). Colorado Department of Public Health and Environment (Denver). https://www.colorado.gov/pacific/sites/default/files/Imm_Kindergarten-Immunization-Survey.pdf.
Charmaz, Kathy. 2002. Qualitative interviewing and grounded theory analysis. In Handbook of interview research: Context and method, ed. Jaber Gubrium and James A. Holstein, 675–694. Thousand Oaks, CA: Sage Publications.
Colgrove, James. 2006. State of immunity: The politics of vaccination in twentieth-century America. Berkeley: University of California.
Collins, Harry M., and Robert Evans. 2002. The third wave of science studies: Studies of expertise and experience. Social Studies of Science 32 (2): 235–296.
Dempsey, Amanda F., Sarah Schaffer, Dianne Singer, Amy Butchart, Matthew Davis, and Gary L. Freed. 2011. Alternative Vaccination schedule preferences among parents of young children. Pediatrics 128 (5): 848–856. https://doi.org/10.1542/peds.2011-0400.
Duggan, Maeve, Amanda Lenhart, Cliff Lampe, and Nicole Ellison. 2015. Parents and social media. Washington, DC: Pew Research Center. http://www.pewinternet.org/2015/07/16/parents-and-social-media/.
Dutton, William H., and Bianca C. Reisdorf. 2017. Cultural divides and digital inequalities: attitudes shaping Internet and social media divides. Information, Communication & Society 22: 1–21.
Epstein, Steven. 2011. Misguided boundary work in studies of expertise: Time to return to the evidence. Critical Policy Studies 5 (3): 323–328.
Eyal, Gil. 2013. For a sociology of expertise: The social origins of the autism epidemic. American Journal of Sociology 118 (4): 863–907. https://doi.org/10.1086/668448.
Fage-Butler, Antoinette Mary. 2017. Risk resistance: Constructing home birth as morally responsible on an online discussion group. Health, Risk & Society 19 (3–4): 130–144.
Giroux, Henry A. 1998. Stealing innocence: the politics of child beauty pageants. The Children’s Culture Reader, 265–82.
Giroux, Henry A. 2004. Cultural studies and the politics of public pedagogy: Making the political more pedagogical. Parallax 10 (2): 73–89.
Hallgrimsdottir, Helga Kristin, and Bryan Eric Benner. 2014. ‘Knowledge is power’: Risk and the moral responsibilities of the expectant mother at the turn of the twentieth century. Health, Risk & Society 16 (1): 7–21. https://doi.org/10.1080/13698575.2013.866216.
Kim, Hensley Owens. 2009. Confronting rhetorical disability: A critical analysis of women’s birth plans. Written Communication 26 (3): 247–272. https://doi.org/10.1177/0741088308329217.
Hidalgo-Lopezosa, Pedro, Maria Aurora Rodríguez-Borrego, and Maria Carmen Muñoz-Villanueva. 2013. Are birth plans associated with improved maternal or neonatal outcomes? MCN The American Journal of Maternal/Child Nursing 38 (3): 150–156.
Kitzinger, Sheila. 2006. Birth crisis. London: Routledge.
Laird, Sam. 2012. The rise of the mommy blogger. Mashable. http://mashable.com/2012/05/08/mommy-blogger-infographic/#t8PhgZjBXEqD.
Lazarus, Ellen S. 1994. What do women want?: Issues of choice, control, and class in pregnancy and childbirth. Medical Anthropology Quarterly 8 (1): 25–46.
Litt, Jacquelyn S. 2000. Medicalized motherhood: Perspectives from the lives of African-American and Jewish women. New Brunswick: Rutgers University Press.
Luke, Carmen. 1996. Feminisms and pedagogies of everyday life. New York: SUNY Press.
Lupton, Deborah. 2012. ‘Precious cargo’: Foetal subjects, risk and reproductive citizenship. Critical Public Health 22 (3): 329–340.
MacDorman, Marian F., and Eugene Declercq. 2016. Trends and characteristics of United States out-of-hospital births 2004–2014: New information on risk status and access to care. Birth 43 (2): 116–124.
MacDorman, Marian F., and Eugene Declercq. 2018. Trends and state variations in out-of-hospital births in the United States, 2004–2017. Birth 46: 279–288.
MacKendrick, Norah. 2018. Better Safe than Sorry. Precautionary Consumption in Everyday Life. Berkeley: University of California Press.
Malacrida, Claudia, and Tiffany Boulton. 2014. The best laid plans? Women’s choices, expectations and experiences in childbirth. Health 18 (1): 41–59.
McCabe, Katharine. 2016. Mothercraft: Birth work and the making of neoliberal mothers. Social Science and Medicine 162: 177–184.
McNutt, Louise-Anne, Cristina Desemone, Erica DeNicola, Hassan El Chebib, Jessica A. Nadeau, Robert A. Bednarczyk, and Jana Shaw. 2016. Affluence as a predictor of vaccine refusal and underimmunization in California private kindergartens. Vaccine 34 (14): 1733–1738.
Michaels, Paula A. 2017. Childbirth and Trauma, 1940s–1980s. Journal of the History of Medicine and Allied Sciences 73 (1): 52–72. https://doi.org/10.1093/jhmas/jrx054.
Morris, Meredith Ringel. 2014. Social networking site use by mothers of young children. In Proceedings of the 17th ACM conference on computer supported cooperative work & social computing, Baltimore, MD.
Namey, Emily E., and Anne Drapkin Lyerly. 2010. The meaning of “control” for childbearing women in the US. Social Science and Medicine 71 (4): 769–776.
Omer, Saad B., Daniel Salmon, Walter A. Orenstein, M. Patricia Dehart, and Neal A. Halsey. 2009. Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. The New England Journal of Medicine 360 (19): 1981–1988.
Paltrow, Lynn M., and Jeanne Flavin. 2013. Arrests of and forced interventions on pregnant women in the United States, 1973–2005: implications for women’s legal status and public health. Journal of Health Politics, Policy and Law 38 (2): 299–343. https://doi.org/10.1215/03616878-1966324.
Parents.com. 2016. Checklist: How to write a birth plan. http://www.parents.com/pregnancy/giving-birth/labor-and-delivery/checklist-birth-plan-penning-pointers/.
Pennell, Angela, Victoria Salo-Coombs, Amy Herring, Fred Spielman, and Karamarie Fecho. 2011. Anesthesia and analgesia—related preferences and outcomes of women who have birth plans. Journal of Midwifery & Women’s Health 56 (4): 376–381.
Reich, Jennifer A. 2005. Fixing families: Parents, power, and the child welfare system. New York: Routledge.
Reich, Jennifer A. 2016. Calling the shots: Why parents reject vaccines. New York: NYU Press.
Reich, Jennifer A. 2018. We are fierce, independent thinkers and intelligent”: Social capital and stigma management among mothers who refuse vaccines. Social Science & Medicine. 20: 18. https://doi.org/10.1016/j.socscimed.2018.10.027.
Sahni, Vanita, Florence Y. Lai, and Shannon E. MacDonald. 2014. Neonatal vitamin K refusal and nonimmunization. Pediatrics 134 (3): 497–503.
Sandlin, Jennifer A., Michael P. O’Malley, and Jake Burdick. 2011. Mapping the complexity of public pedagogy scholarship:1894–2010. Review of Educational Research 81: 338–375. https://doi.org/10.3102/0034654311413395.
Simkin, Penny. 2007. Birth plans: After 25 years, women still want to be heard. Birth 34: 49–51.
Smith, Naomi, and Tim Graham. 2017. Mapping the anti-vaccination movement on Facebook. Information, Communication & Society 22: 1310–1327.
Spock, Benjamin 1998. Dr. Spock’s baby and child care, 7th ed. Pocket Books. Reprint, parents.com.
Springgay, Stephanie, and Debra M. Freedman. 2010. Breasted Bodies as Pedagogies of Excess. In Handbook of public pedagogy: Education and learning beyond schooling, ed. Jennifer A. Sandlin, Brian D. Schultz, and Jake Burdick, 351. Boca Raton: CRC Press.
Staver, Anna. 2019. Colorado’s worst-in-the-nation measles vaccination rate drops again. Denver Post. https://www.denverpost.com/2019/06/13/colorado-vaccination-measles-immunization-2019/. Accessed 13 June 2019
Tangherlini, Timothy R., Vwani Roychowdhury, Beth Glenn, Catherine M. Crespi, Roja Bandari, Akshay Wadia, Misagh Falahi, Ehsan Ebrahimzadeh, and Roshan Bastani. 2016. “Mommy blogs” and the vaccination exemption narrative: Results from a machine-learning approach for story aggregation on parenting social media sites. JMIR Public Health and Surveillance 2 (2): e166.
Taylor, Verta, and Lisa Leitz. 2010. Emotions and identity in self-help movements. In Social movements and the transformation of American Health Care, ed. Jane C. Banaszak-Holl, Sandra R. Levitsky, and Mayer N. Zald, 266–283. New York: Oxford University Press.
Tolentino, Jia. 2017. Ivanka Trump wrote a painfully oblivious book for basically no one. The New Yorker 4.
Tropp, Laura. 2006. “Faking a sonogram”: Representations of motherhood on sex and the city. The Journal of Popular Culture 39 (5): 861–877.
WebMD. 2019. How to create your birth plan. https://www.webmd.com/baby/guide/how-to-create-a-birth-plan#1.
What to Expect. 2018. Popular topics in pregnancy and parenting on what to expect. https://www.whattoexpect.com/popular-topics. Accessed 17 December 2018.
Zwelling, Elaine. 2008. The emergence of high-tech birthing. Journal of Obstetric, Gynecologic, and Neonatal Nursing 37 (1): 85–93.
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The author is grateful to Laura Carpenter, Norah MacKendrick, Rene Almeling, Joanna Kempner, Anna Kirkland, and the anonymous reviewers for helpful feedback in developing this article.
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Reich, J.A. Teaching women to question and control: public pedagogies of birth and vaccine refusal. BioSocieties 15, 580–600 (2020). https://doi.org/10.1057/s41292-019-00168-2
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DOI: https://doi.org/10.1057/s41292-019-00168-2