Title page for ETD etd-04062006-162429

Type of Document Master's Thesis
Author Wydra, Michelle M.
Author's Email Address mwydra1@lsu.edu
URN etd-04062006-162429
Title From the Top Down and the Bottom Up: the Contemporary Practice and Choice of Midwifery in Louisiana
Degree Master of Arts (M.A.)
Department Geography & Anthropology
Advisory Committee
Advisor Name Title
Robert Tague Committee Chair
Jill Brody Committee Member
Miles Richardson Committee Member
  • birth
  • midwifery
  • obstetrics
  • Louisiana
Date of Defense 2006-03-17
Availability unrestricted
This research examines the contemporary practice of midwifery in Louisiana, a state that very early on had progressive legislation, yet remains a tough place for a midwife to practice. What, then, are the social forces that affect the ability to practice midwifery in Louisiana? I try to answer that question by examining the narratives of midwives and their clients, and evaluating the options these women have access to in this state.

The narratives provide opportunities to observe the authoritarian knowledge of biomedicine in our society, and apply Foucaultís theory of power/knowledge. I describe that although Louisianaís regulation of the practice was progressive when written, the regulation alone cannot guarantee access to midwifery. I also deconstruct the meaning of choice, a phenomenon that involves not merely the existence of alternatives, but real ways of accessing them equally. Efforts to employ midwives and have a home birth are often thwarted by biomedicine, law, private insurance, and Medicaid. Additionally, the social sanctions against midwifery clients can be painful. This research demonstrates that an out-of-hospital birth, while legal, is not easily available or practiced by women in Louisiana.

Using anthropological skills to understand the complexity of choice for midwives and their clients in Louisiana also offers me the opportunity to consider how the social forces shaping that choice might better work with midwifery. Working as an applied anthropologist provides the chance to engage in change with the community. Making this research available to women who consider this choice or have already struggled to make it is a first and crucial step in that engagement.

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