"'No Room for 'Rooming-in'? Gender, Risks and Competing Moralities around Birth Care Innovations in Czechoslovakia in the Early 1980s"
Abstract
In the early 1980s, several revolutionary innovations were introduced in some Czechoslovak hospitals. Among these, the 'rooming-in' (RI) presented a radical departure from an established postpartum regimen of care, as it allowed new mothers to have their newborns with them all - or most of - the time. Until then, newborns and their mothers were placed in separate units and saw each other only when pediatric nurses brought babies to be breastfed. Despite obvious health benefits for both a newborn and his/her mother and their mutual bonding that significantly improved rates of breastfeeding and neonatal outcomes, innovation sparked heated debates among health professionals in gynecology, pediatrics, and nursing on pages of their leading journals as well as among lay people in daily and popular lifestyle magazines. Although psychologists called for immediate rebuilding of the maternity wards into appropriate rooms, several head obstetricians together with pediatric nurses were reluctant to adopt such changes and/or were outspoken against this practice. Critics denounced a new practice as a 'Western fad' while pointing to several risks and disadvantages: there were economic costs of rebuilding the wards, legal issues (the new arrangement was not addressed in the official Neonatal Concept even though it did not explicitly prevent healthcare providers from establishing the rooming-in), and health concerns about the spread of nosocomial infections. However, subsequent studies showed that in some facilities the RI regimen in fact reduced the rates of nosocomial infections among neonates. The printed lay opinions oscillated between the appraisals of the practice and its condemnation as a 'tyranny against a postpartum woman' who has no time for rest (e.g. The Mladý svet Magazine, 1983).
This paper focuses on the practice of 'rooming-in', and on various constructions of 'risks' that it evokes. I build here on the qualitative analysis of printed contributions in medical journals such as the Czechoslovak Gynecology, Czechoslovak Pediatric, or The Female Health worker and in popular mass media (e.g. Rudé právo Daily; Mladá fronta Daily; the Mladý svet Magazine, etc.). I take the debates around the RI regimen as a point of departure to explore broader shifts in thinking about mother-newborn relations and 'healthy family', appropriate postpartum care, professional disputes and how they were gendered, and a shifting position of an individual person in the healthcare system with a 'collective' ethos. My aim is to grasp a changing paradigm of what matters in postpartum care, and what competing moralities accompany arguments for (or against) change.