'Nobody in a maternity hospital really talks to you': Socialist legacies and consumerism in Czech women's childbirth narratives

Abstract

This article aims to show how eight women, most of them with higher education, experienced, perceived, and understood birth care in the context of the post-socialist transformation in the Czech Republic. It is based on narrative interviews and a thematic analysis of them. From a description of women's birth-care experiences the author finds that women are most critical of the behaviour of health-care workers and the lack of communication provided by the system. Discussing the narrators' birth-care requirements she notes the strategies women use to attain the form of care they wished. Finally, the author observes that the women she interviewed exhibit diverse understandings of birth care, on which basis the author identifies five distinct notions of birth care that differ in three key aspects: (1) women's attitudes to medical interventions; (2) their awareness of birth care; (3) their subjectivity and position in relation to birth-care providers. These ranged from complete acceptance of the way in which birth care is provided, to notions that are critical but accepting of medicalised care, to a rejection of the medical model of birth care and the assumption of 'a responsible consumer' subjectivity. The article in particular looks at women's disillusionment with birth care and interprets it in relation to clashing ideas about the relationship between birthcare provider and user associated on one hand with the socialist past and on the other with neo-liberal discourses on health.