Stephanie Paterson

Feminizing obstetrics or medicalizing midwifery? The discursive constitution of midwifery in Ontario, Canada

The politics of midwifery in Ontario, Canada, offers rich insights into feminist policy and policy analysis, illuminating both challenges and opportunities for social change. In this article, I employ the discourse coalitions framework to investigate the claims-making process during early debates of midwifery. I argue that early midwifery advocates framed the debate around the issue of patriarchal politics, connecting the ‘colonization of wombs’ with gender inequality more generally. Once entering mainstream public dialogue, however, the rhetorical power of the scientific-medical discourse proved too strong, prompting midwifery advocates to employ frames congruent with its principles, including competence, safety, and expertise. The effect was twofold: first, it created an observable cleavage between pragmatic and radical midwives and midwife supporters; second, the resulting legislation, rather than offering a challenge to the scientific-medical model, actually served to reproduce it. In doing so, it has effectively objectified the birthing woman, replacing the physician as primary decision-maker with an ‘expert midwife’, while obscuring and potentially silencing claims for reproductive autonomy.

From quacks to professionals: the importance of changing social constructions in the policy-making process

The social construction of target populations (SCTP) approach assumes that policies are constructed to benefit (or punish) specific groups of citizens based on their relative power and social construction. This contribution tackles one of the most sustained critiques of the SCTP literature, namely, how a group can alter its social construction and power. Stated differently, how does a group move from being constructed as dependent or deviant to contenders or advantaged? In 1991, the government in Ontario, Canada, proclaimed what is arguably the most progressive midwifery legislation in the world. The Midwifery Act established midwifery as a self-regulating profession, fully integrated into the provinces public health insurance system, and enables midwives to catch babies in hospitals, homes and birthing centres. What is striking about the legislation is the contentious debate preceding it, in which midwives were constructed as ‘quacks’, incompetent and unclean, compared to professional physicians. In this paper, we explore the role of commissions of inquiries (COI) in shifting social constructions. Specifically, we argue that COI legitimised the authoritative knowledge of moral entrepreneurs and facilitated the necessary interaction between moral and political entrepreneurs, which in turn reconstructed midwives from ‘quacks’ to experts, and resulted in significant policy change.

Negotiating the Complexities and Risks of Interdisciplinary Qualitative Research

This article interrogates the experiences of an interdisciplinary research team that engaged in a qualitative research program for over 5 years, beginning with the grant writing process through to knowledge dissemination. We highlight the challenges of constructing shared understanding and developing research synergies, embracing vulnerability and discomfort to advance knowledge, and negotiating risks of legitimacy and transcending disciplinary boundaries. Based on critical reflections from the research team, the findings call attention to the politics of knowledge production, the internal and external obstacles, and the open mindedness and emotional sensitivity necessary for interdisciplinary qualitative research. Emphasis is placed on relational and structural processes and mechanisms to negotiate these challenges and the potential for interdisciplinary research to enhance the significance of scholarly work.

Rethinking the Dynamics of Abusive Relationships: The Implications of Violence and Resistance for Household Bargaining

Integrating insights from strategic bargaining analysis with the cooperative conflicts approach, this paper explores the implications of conjugal violence against women and women’s resistance to violence for bargaining processes and outcomes. It is argued that analyses of conjugal violence must situate strategic behavior in social context, thus problematizing theoretical and empirical analyses that point to a direct negative correlation between women’s economic resources and violence. The paper concludes with a brief discussion of policy implications. JEL classifications: D13, D19

Conditional and Unconditional Cash Transfers: Implications for Gender

Abstract Solving poverty is a laudable public policy goal. While there are many approaches, one that has gained popularity is the conditional cash transfer that requires recipients to satisfy conditions imposed on them such as requiring regular medical checkups. Another approach, which is gaining interest is unconditional cash transfers that do not impose conditions. The question we ask in this paper is: what do these past and current attempts tell us about the implications for gender? To answer this question, we explore two programs using a gendered framework: Brazils Bolsa Familia,which is a conditional cash transfer, and Manitobas Mincome experiment, which was an unconditional cash transfer in Canada. We then consider how this information might be used by states, particularly as it relates to ending social marginalization. Broadly, this research contributes to academic discussions of public policy, income, gender and social vulnerability.

Gendering Public Policy or Rationalizing Gender? Strategic Interventions and GBA+ Practice in Canada

The debate surrounding the transformative potential of gender mainstreaming has revived concerns of co-optation of equality work and resistance first expressed by early feminist public administration scholars. In this article, we explore how gender analysts exercised their agency and carved out spaces within the bureaucracy to articulate and advance a gender focus in policy work. Employing discursive, institutional and relational strategies, gender analysts simultaneously used and pushed back against hierarchical bureaucratic discourses as they operationalized Gender-Based Analysis Plus (GBA+) in the federal public bureaucracy. These micro-level acts of resistance, on their own, do not lead to social transformation. However, by creating spaces for feminist knowledge and activism within the state, these local strategies can contribute to the broader feminist agenda.

Gender Mainstreaming and the Discursive Politics of Public Service Values

ABSTRACT In this article, we argue that the introduction of gender mainstreaming invites tension between key public service values, such as fairness, equity, and responsiveness, on one hand, and efficiency, accountability, and neutrality, on the other hand. Using a Canadian case study, we further argue that, to reconcile this conflict, public servants deploy a number of discursive strategies, which shape the meanings of both gender mainstreaming and values. These tactics, we suggest, serve to both trouble and reinscribe traditional bureaucratic discourse in ways that might offer opportunities for transforming administrative practice and policy outcomes.