Abstract | Doktorska disertacija temelji se na prvom takve vrste etnografskom istraživanju iskustva, doživljaja i praksi prirodnog porođaja. Svrha je ovoga rada analizirati promjene porođajnih praksi druge polovine 20. i početka 21. stoljeća. Istraživanje je provedeno s rodiljama, primaljama, opstetričarima i doulama. Jedno od središnjih pitanja na koja rad odgovara jest zašto se žene odlučuju na porođaj bez liječnika izvan rodilišta te što one podrazumijevaju pod konceptom prirodnog porođaja. Rad istražuje u kakvom su odnosu zakonodavne promjene, maternalna skrb i porođajne prakse unutar dominantnog biomedicinskog pristupa i holističkog primaljskog pristupa. Istraživanje prirodnoga porođaja bavi se zagovornicama prirodnoga porođaja s ciljem ostvarivanja većih reproduktivnih prava žena. Rezultati ovog istraživanja pokazuju da se zahtjev za legalizaciju prirodnih porođaja i postojećih praksi porođaja kod kuće temelji na snažnim osjećajima nemoći, otuđenosti i neravnopravnog odnosa liječnika i rodilje u porođajima unutar medicinskih ustanova. S druge strane, rezultati istraživanja s rodiljama koje su rodile prirodnim putem kod kuće uz primalje i doule ukazuju na to da su nove prakse porođaja omogućile ostvarivanje većeg tjelesnog i emocionalnog integriteta rodilja, snažnu povezanost s djetetom i obitelji kroz sam porođaj i nakon njega te su, u konačnici, doprinijele osnaživanju rodilja. Istraživanje pokazuje da je pokret prirodnog porođaja proizašao iz reakcije na biomedicinski model porođaja. To ukazuje na potrebu revizije medicinskih protokola i institucionalnog okružja, edukacije medicinskog osoblja, kao na i nužnost otvaranja zakonskog prostora za nedvosmislenu pravnu regulaciju prirodnog porođaja te osiguravanja autonomije rada primalja u vođenju fizioloških nerizičnih porođaja i asistencije doula. S obzirom na to da je riječ o inovativnom istraživanju, ono potencijalno može pridonijeti razvoju relevantnih novih uvida u nizu antropoloških grana. To se posebice odnosi na grane feminističke antropologije, medicinske antropologije, antropologije majčinstva i obitelji. Isto tako, istraživanje može ostvariti upliv na druge društvene znanosti poput sociologije; biomedicinske znanosti poput javnog zdravstva i opstetricije, koje mogu implementirati njegove rezultate i uvide. Na kraju valja naglasiti da je jedan od značajnijih izvornih doprinosa istraživanja primjenjiv i u oblikovanju budućih zdravstvenih politika koje bi se temeljile na kvalitativnometodološkoj detekciji potreba i interesa rodilja. |
Abstract (english) | This dissertation is based on the first ethnographic research of its kind on the experience and practices of natural childbirth. The purpose of this work is to analyze changes in childbirth practices in the second half of the 20th century and the beginning of the 21st century. The research was conducted with birthing mothers, midwives, obstetricians, and doulas. One of the central questions that this dissertation answers is why women decide to give birth without a doctor outside the maternity ward and what they mean by the concept of natural birth. This doctoral thesis investigates the relationship between legislative changes, maternal care, and childbirth practices within the dominant biomedical approach and the holistic midwifery approach. The legal ambiguities and disorganization related to out-of-institutional births point to the need for a revision of the legislation that would enable women who give birth at home to have the same health care as women who give birth in maternity wards. Although the practice of giving birth in a maternity hospital is generally accepted, the experiences of women show in a noticeable number of cases that, despite the laws that ensure their rights as patients, the right to self-determination, understandable and adequate information, appreciation and respect is not respected within the institutions. All this forms the basis of the criticism of institutional childbirth, which, along with the criticism of excessive use of technology, shapes the desirability of childbirth at home as a place where the mother will have guaranteed autonomy, support, and midwifery care, which will be discussed in the following chapters. Natural childbirth research deals with advocates of natural childbirth intending to achieve greater reproductive rights for women. The results of this research show that the demand for the legalization of natural births and existing home birth practices is based on a strong feeling of powerlessness, alienation, and unequal relationship between doctors and midwives in births within medical institutions. On the other hand, the results of the research with mothers who gave birth naturally at home with midwives and doulas, indicate that new birthing practices made it possible to achieve greater physical and emotional integrity of the mother, a strong connection with the child and family during the birth itself and after it. and ultimately contributed to the empowerment of mothers. Research shows that the natural childbirth movement arose out of a reaction to the biomedical model of childbirth. This indicates the need for revision of medical protocols, institutional environment, and education of medical staff as the opening of legal space for the unambiguous legal regulation of natural childbirth, the autonomy of work of midwives in conducting physiological risk-free births, and doula assistance. The research has a strong potential to contribute to the development of new insights in several anthropological branches, given that it is an innovative research. In particular, the branches of feminist anthropology, medical anthropology, anthropology of motherhood, and family are meant. Likewise, research can have an impact on other social sciences such as sociology, and biomedical sciences such as public health and obstetrics, which can implement the results and insights of this research. Finally, it should be emphasized that one of the more significant original contributions of the research is also applicable in the design of future health policies that would be based on the qualitative-methodological detection of the needs and interests of women in labor. |