Childbirth and medical pluralism in multiethnic Mexico
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This work is based on sixteen months of in-depth fieldwork related to medical pluralism surrounding birth, ethnicity, and class, and how these three vectors are influenced by global flows traversing the Mexican landscape. How do intersecting birth models in Mexico unfold on the physical and social body in disparate ways, depending on the geographical context, socioeconomic status, and education level of patients? The article is sensitive to the inequality (socioeconomic, gender, and racial) that medical pluralism often meets and comes to represent, and argues that the positive capacity of medical pluralism to meet the disparate needs of people in different geographical, cultural, and ethnic contexts should not be distorted or used to disguise and obscure the suffering of people living in poverty, and victimized by racial discrimination and structural persecution. How do the methods applied by different types of birth attendants ("traditional midwives", "professional midwives", obstetricians, and obstetric nurses) respond to the reproductive health care needs and preferences of Mexican women across ethnic groups, socioeconomic class, and geopolitical divisions? Only through problematizing pluralism in birth practices in Mexico (i.e., "traditional", biomedical, and humanized) can we truly understand the challenges that continue to undermine gender equity, reproduce maternal mortality, and limit the development of effective and appropriate health care across ethnicity, space, and place. This article takes hybridity as its object as well as its methodological project. I engage theory from both the United States and Mexico to examine interpenetrations between transnational birth models and problematize hegemonic dichotomies such as tradition-modernity, north-south, and local-global. Thus, the article resists the temptation to condemn obstetricians and romanticize midwives, and vice versa. Using "border thinking" and my own "border identity" to engage with subaltern perspectives, I make my work multi-sited not only in the geographic sense but perform research across ethnic and socioeconomic grades.