Compliance as strategy: the importance of personalised relations in obstetric practice

• Published in: Social science & medicine (1982) 2004-11, Vol.59 (10), p.2053-2069
• Main Author: Tanassi, Lucia M.
• Format: Article
• Language: English
• Subjects: Agency; Agency and Structure; Anthropology, Cultural; Compliance; Ethnography; Female; Females; Health professional-Patient relationships; Health Services Research; Hospital; Hospital Ethnography Obstetrics Agency Maternal health Italy; Hospital-Patient Relations; Hospitals; Humans; Italy; Maternal health; Maternal Welfare - ethnology; Mothers; Observation; Obstetrics; Obstetrics and Gynecology Department, Hospital - organization & administration; Organizational Culture; Organizational Structure; Patient Compliance - ethnology; Physician patient relationships; Physician-Patient Relations; Practitioner Patient Relationship; Pregnancy; Pregnant women; Sociology, Medical; Subjectivity
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2004.03.009

This paper highlights the importance of personalised relations in institutionalised obstetric care. It seeks to explore the link between objectification and agency, by examining the way in which women find a new subjectivity in motherhood within the walls of the obstetric institution. The paper focuses on obstetric encounters through the lens of labour and intrapartum routine procedures, and argues that when expectant women enter the obstetric institution, a series of relations ensue through their efforts to become connected with the official obstetric system. The hospital organisation and network of relations that originate in it reflect and reproduce a passive role for expectant women and mothers; however, it would be misleading to represent their behaviour as simply “compliant”. Expectant mothers value the connectedness with the obstetric system exemplified by personalised patient–practitioner relations because it is a guarantee of safety. They are happy to follow clinicians’ instructions, even when this implies significant sacrifice or suffering because they are projected towards fulfilling their parenting desires. Compliance, like resistance then, is here intended to be understood as yet another maternal strategy, and as such it is the most widespread, deployed by women in order to achieve their ideals and desires.