Negotiated Breastfeeding by Caroline Chautems

Author:Caroline Chautems [Chautems, Caroline]
Language: eng
Format: epub
ISBN: 9780367643522
Barnesnoble:
Goodreads: 57932671
Publisher: Routledge
Published: 2021-10-19T00:00:00+00:00

Similarly, by acting on the basis of parents’ feelings and experiential knowledge, as well as their own experiential knowledge regarding the management of newborns’ failure to thrive, midwives take a hard stance against the biomedical model of risk management. However, the postpartum period, unlike delivery, is not defined by medical authorities as a “fateful moment” (Scamell & Alaszewski 2012). In the case of a baby’s weight stagnation, the urgency of birth is over, and the situation can be handled more flexibly. In this context, midwives concentrate on the paediatrician’s one-month check-up, which acts as a normative “call to order”. For this only institutionalised marker involving “a third person”, as Capucine said, during the postpartum follow-up, midwives are held accountable for the baby’s health. Midwives are torn between their commitment to their holistic care practices and their projections of paediatricians’ expectations, as they must maintain their credibility and authority with paediatricians and parents.

In parallel, midwives establish themselves as the defenders of a range of controversial infant care practices, such as bed-sharing and non-vaccination, creating a personalised model of risk management that they share with parents. Bed-sharing, for example, is perceived in this model as a protective practice that supports breastsleeping (McKenna & Gettler 2016). In the same vein, non-vaccination is connected to breastfeeding practices because breast milk allows infants to build immunity resistance, whereas vaccination prevents babies from “building their immunity”. From this perspective, commitment to breastfeeding leads parents and midwives to a custom model of risk perception and management.

Midwives expressed a strong critical stance against the weight-centric evaluation of breastfeeding success and newborns’ health, defending the specificity of independent midwifery care. Midwives also perceived a qualitative approach as part of an empowerment process for parents. Parents tended, for their part, to embrace their midwives’ committed position, often showing an obvious disinterest in their child’s weight. At the same time, although midwives claimed that weighing babies was not the highlight of their visit, the act is part of midwives’ consultation accountability and has become, in a certain way, emblematic of the independent midwife practice, as opposed to other less action-oriented moments.

However, in cases of failure to thrive, the baby’s weight remains essential, focusing parents’ and midwives’ expectations. As Odile said, “You need to see if what you put in place actually works”. The actions implemented to improve infants’ weight gain were nevertheless discussed and negotiated at length with parents, engaging midwives in a tinkering care process involving constant readjustments intended to respect parents’ wishes as part of a “logic of care” (Mol 2009).

Controversial but unavoidable, the weighing of babies remains a symbolic ritual of the postpartum home follow-up. As the only quantified, “objectified” data from a follow-up based on observing, listening, and feeling, the baby’s weight highlights a breaking point between the midwives’ care model, their professional responsibility to ensure babies’ health and the parents, the informed and “enlightened” interlocutors with whom they negotiate.

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