Mary Lay Schuster on Material Rhetoric and Midwifery

I've been meaning to blog this for weeks. I recently attended a thought-provoking talk given by my adviser, Mary Lay Schuster, in the monthly "Rhetoric Parlor" series of colloquia we have in our department, titled "A Different Place to Birth: A Material Rhetorical Analysis of BabyHaven, a Free-Standing Baby Center." Schuster has been doing research on midwifery for years now. She has done analyses of the legal status of midwifery practices after Roe v. Wade and insightful Foucaultian/feminist critiques of the tension between the knowledge systems of the medical establishment and midwifery, which, according to cultural norms, is situated as an alternative knowledge system placing more authority in "embodied knowledge." I'll be quick to point out, however, as Schuster would, that there's always overlap and a degree of cooperation between the two systems (for example, some physicians supply midwives with pitocin and other materials on the sly). Her most recent work, on which this talk was based, centers on material rhetoric as an analytical tool for analyzing spaces, in this case a birthing center. In spring 2003, she taught a seminar on gender and the rhetoric of science and technology, in which we read a lot about material rhetoric and the body, including Rhetorical Bodies, a collection of essays edited by Jack Selzer and Sharon Crowley, and Feminism and the Body, a collection of essays edited by Londa Schiebinger, both of which I'd highly recommend if you're at all interested in this stuff. These texts, particularly the former, which contains Carole Blair's essay, "Contemporary US Memorial Sites as Exemplars of Rhetoric's Materiality," inform her work.

Schuster started out by defining key terms. She explained the difference between direct-entry midwives and nurse-midwives. Direct-entry midwives are not formally schooled but do apprenticeships under other midwives, whereas nurse-midwives work under the supervision of physicians. She also cited a definition of material rhetoric from Barbara Dixon's essay in Rhetorical Bodies material rhetoric is a space where "multiple discourses and multiple material practices collude and collide." She invoked Blair's five-question theoretical framework for studying material sites as rhetoric:

1. What is the significance of the text’s material existence?
2. What are the apparatuses and degrees of durability displayed by the text?
3. What are the text’s modes or possibilities of reproduction or preservation?
4. What does the text do to (or with, or against) other texts?
5. How does the text act on people?” (p. 23)

Other assumptions that guided her thinking included the study of mind and body in relation and the assumption that cultural norms mediate the body and the ways the self experiences the body. We experience cultural inscriptions and natural sensations simultaneously. To further describe her thinking, she reviewed two models of birth with their own particular sets of norms: the medical model, in which birth is managed and the laboring body is perceived as "risky" and in need of control in the form of objects such as fetal heart monitors and procedures such as epidurals, and the midwifery model, in which labor and birth are not so pathologized, and medical objects are hidden from view (at least in the case of BabyHaven), except the oxygen tank, which is too large to hide. Simply put, the medical model often assumes something will go wrong, and the midwifery model assumes that nothing will go wrong but are prepared for medical emergencies should they arise.

Schuster provided excerpts from the interviews she had done with women who had given birth at the birthing center, and while there's no way I can do her presentation justice, I'll point to a few of Schuster's key interpretations. She articulated the problem of balancing her observations with those of her participants. As a result, her interpretation of the space was influenced by her participants' accounts of their experiences in the space. One pattern she noticed was "materializing privacy." The physical space of the center (the text, according to Blair's framework), acts on people by helping to create the perception of privacy. The positive experience of privacy, created by the homelike decor, locking of doors during a birth, and closing of curtains, enabled the women to relax and better cope with pain. One tangible benefit of the material rhetoric of BabyHaven is that the women don't require drugs to cope with pain. Specific objects at the center, such as the large tub of water in the room and the birthing ball, also enhanced the women's experience of birth. The tub made women feel in control and helped them avoid pushing too soon. To use Blair's term, BabyHaven, considered as a text, has several consequences, including contributing to the resistance of the medical hegemonic norm that the laboring body is in need of control. BabyHaven rewrites cultural assumptions about where the laboring body can be safe; Schuster makes this point in reference to the tub, which physicians rarely allow laboring women to use because of the perceived risk of infection or, it could be argued, the perceived jeopardy of the laboring body and fetus. Finally, BabyHaven helps to create a positive experience of privacy in which women can bond with babies differently and more easily. It was an excellent presentation, and Schuster will be publishing an article based on this study soon. When it comes out, I'll post the citation here.