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No Perfect Birth

Trauma and Obstetric Care in the Rural United States
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In No Perfect Birth: Trauma and Obstetric Care in the Rural United States, Kristin Haltinner examines the institutional and ideological forces that cause harm to women in childbirth in the rural United States. Interweaving the poignant and tragic stories of mothers with existing research on obstetric care and social theories, Haltinner points to how a medical staff's lack of time, a mother's need to navigate and traverse complex spaces, and a practitioner's reliance on well-trodden obstetric routines cause unnecessary and lasting harm for women in childbirth. Additionally, Haltinner offers suggestions towards improving current practices, incorporating case models from other countries as well as mothers' embodied knowledge.
Kristin Haltinner is associate professor of sociology at the University of Idaho.
Chapter 1: "The Most Horrible Part:" The Trauma Imposed by Time Chapter 2: "Worse Than the Birth:" The Trauma Imposed by Space Chapter 3: "That's Problematic:" The Trauma Imposed by Routine Chapter 4: "Open Your Legs:" Time, Space, Routine and Obstetric Violence Chapter 5: "We Perpetuate the Patriarchy:" The Trauma Imposed by Societal Knowledge Chapter 6: "I Just Hated Him:" The Impact of Trauma on Women's Relationships Chapter 7: "He Was So Supportive:" Using Power and Restructuring Obstetric Care Conclusion: Changing Knowledge
This worthwhile, grounded study features women's stories, a historical perspective, the recognition of power, and the possibility of change. Haltinner appropriately utilizes Michel Foucault's theories to emphasize three key elements of time, space, and routine that contribute to women's traumatic birth experiences. The self-identified women from the rural northwestern US with whom Haltinner spoke give voice to their perceived trauma due to their lack of control, which shines a negative light on providers and the larger health care system against a backdrop of patriarchy, violence, hatred, support, and invisibility. The author presents Finland's structure of government-funded obstetric care and Germany's postpartum mental health support to underscore the need for social change in the US through free universal health coverage along with reforms to address mental health, family leave, and other changes to health care.... Recommended. General readers through faculty; professionals. * Choice Reviews * Kristin Haltinner's book provides a salient analysis of the institutional and ideological practices that routinely traumatize birthing people in the United States. Her work not only illustrates how capitalism intersects with patriarchy, classism, and racism within medical institutions, but also, most importantly, gives us the tools we need to understand and intervene on the actions and beliefs that lead to obstetric violence. By centering women's voices and experiences, this book provides us with discursive and tangible ways to improve care for birthing people in the U.S. This book is an urgent and timely intervention that can be used to help improve birth experiences and outcomes. -- Alison Happel-Parkins, University of Memphis In her detailed account of birth trauma, Haltinner underscores the structures that put mothers, and sometimes even their doctors, in systems that hurt women's bodies, minds, and souls. Focusing on rural communities, this book is grounded in a sophisticated theoretical framework that pushes us to situate birth trauma within a political, economic, and gendered social structure. A profoundly insightful examination of birth that centers women, their experiences, and voices while laying bare the impact traumatic birth leaves, this is a powerfully written and totally heartbreaking book. -- Ryanne Pilgeram, University of Idaho In No Perfect Birth, Kristin Haltinner adds to the critically necessary body of scholarship on traumatic birth in a fashion that profiles the knowledge-generating authority in the voices of her respondents. Her account illuminates the governing, institutional power that operates in the birthing encounter as a force that both creates and destroys, then proliferates and forecloses, and can harm and heal. The wisdom of those who birth is best showcased in the moments when Haltinner speaks with her subjects about how their violent or traumatic laboring and recovery could have been different (and indeed are sometimes different, elsewhere in the world, outside of the U.S.)-time reclaimed, separations bridged, space reorganized, and routines rethought to place parent-infant bonds before profits and private interests. By placing the voices of mothers at the radial point of generative knowledge, Haltinner's text offers the promise of social science at its best. Responsibility for obstetric violence is shared by both individuals and institutions, and most importantly, social change is conceptualized as complex, long, messy, and large, and yet also comprised of micro-level, small, individual acts such as withdrawing consent, refusing participation, uttering a singularly radical 'no,' and claiming the balm that comes through recounting our traumatic birth stories as tales of survival. -- Danielle Docka-Filipek, Christopher Newport University
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