Assessing Motherhood: The construction, assessment, and management of ‘vulnerable’ pregnant women by Dutch care providers
In recent years, Dutch obstetric care has had an elevated focus on the early recognition and prevention of psychosocial problems in pregnant women. Women in whom psychosocial problems are identified are grouped under the term ‘vulnerable’ pregnant women. Standardized risk screenings were developed to help obstetric care providers identify possible psychosocial issues. What is considered as a risk factor during pregnancy, however, is not neutral. Rather, risks are indicative of common societal values, norms and moral judgments (Douglas 1992). For this thesis, I interviewed care providers from various disciplines about the screening and care of ‘vulnerable’ pregnant women. Through the theoretical lens of ‘risk’, I seek to begin to fill the current gap in anthropological literature on the construction, assessment, and management of ‘vulnerable’ pregnant women by health care providers in the Netherlands. I discuss how the knowledge produced by the use of standardized questionnaires, that focus primarily on the detection of risk factors in expecting mothers, is in practice supplemented and sometimes supplanted by other, tacit or intuitive, ways of knowing. I then analyze the ‘multiplicity’ of the concept of ‘vulnerable’ pregnant women, since this is a category that is enacted in many different ways and settings. Finally, I will argue how risk assessment can come to compromise the building of a trust relationship between provider and client.
Assessing Motherhood: The construction, assessment, and management of ‘vulnerable’ pregnant women by Dutch care providers
In recent years, Dutch obstetric care has had an elevated focus on the early recognition and prevention of psychosocial problems in pregnant women. Women in whom psychosocial problems are identified are grouped under the term ‘vulnerable’ pregnant women. Standardized risk screenings were developed to help obstetric care providers identify possible psychosocial issues. What is considered as a risk factor during pregnancy, however, is not neutral. Rather, risks are indicative of common societal values, norms and moral judgments (Douglas 1992). For this thesis, I interviewed care providers from various disciplines about the screening and care of ‘vulnerable’ pregnant women. Through the theoretical lens of ‘risk’, I seek to begin to fill the current gap in anthropological literature on the construction, assessment, and management of ‘vulnerable’ pregnant women by health care providers in the Netherlands. I discuss how the knowledge produced by the use of standardized questionnaires, that focus primarily on the detection of risk factors in expecting mothers, is in practice supplemented and sometimes supplanted by other, tacit or intuitive, ways of knowing. I then analyze the ‘multiplicity’ of the concept of ‘vulnerable’ pregnant women, since this is a category that is enacted in many different ways and settings. Finally, I will argue how risk assessment can come to compromise the building of a trust relationship between provider and client.
