Doing Qualitative Research

The Woman in the Body: A Cultural Analysis of Reproduction by Emily Martin Beacon Press, 1987 Paperback, 276 pp $1195 Winner of the 1988 Eileen Basker Memorial Prize As anthropology at its best can do, this book exposes hidden cultural assumptions about the nature of reality Martin has produced a powerful study of the dialectic between medical metaphors for women's reproductive processes and women's own views of those processes She and her associates interviewed 165 white and black women, seeking a balance between the three life stages of puberty, childbearing, and menopause 43% of her interviewees were working-class; 57% middleclass Early on Martin came up against one of the greatest dangers of studying one's own society Hearing women discuss uterine contractions as separate from the self and labor as something one "went through," and reading the same in medical texts, she at first thought that her interviews had turned up views of the body that simply reflected actual scientific fact It took her some time to realize that such scientific views are not "fact" but culturally grounded statements of an underlying ideology To get at this ideology Martin studied medical texts for the "grammar" that scientific medicine uses to describe female bodies In this medical grammar, she finds industrial society writ small The female reproductive tract is a machine designed to produce a baby; accordingly, menstruation represents failed production, connoting both a productive system that has failed to produce and one that produces only useless waste Such metaphors, disturbing to a society whose existence depends upon continued production, lead to menstruation's description in medical texts in highly negative terms: The fall in blood progesterone and estrogen, which results from regression of the corpus luteum, deprives the highly developed endometrial lining of its hormonal support    Disintegration starts    The endometrial arteries dilate, resulting in hemorrhage through the weakened capillary walls; the menstrual flow consists of this blood mixed with endometrial debris    (quoted on p 48) (Martin contrasts this with a description of male reproductive physiology which speaks of the "remarkable" cellular transformation from spermatid to mature sperm, its "amazing" nature and "sheer magnitude") Confronting the argument that the above is not value-laden but simply a factual description of menstruation, Martin examines medical descriptions of the analogous regular shedding and replacement of the lining of the stomach, finding in a number of texts no references to degeneration, but instead a stress on the periodic "renewal" of the stomach lining Concluding that writers can choose to depict what happens to the lining of stomachs and uteruses either negatively as breakdown and decay or positively as continual production and replenishment, Martin suggests an alternative medical description of menstruation: A drop in the formerly high levels of progesterone and estrogen creates the appropriate environment for reducing the excess layers of endometrial tissue Constriction of capillary blood vessels causes a lower level of oxygen and nutrients and paves the way for a vigorous production of menstrual fluids    Such a description would far more accurately reflect women's own more positive assessments of the menstrual fluid as the desired product Viewing pregnancy as the sole purpose of female reproductive organs and despising menstruation as a "waste" ignores the reality that most women do not intend to get pregnant most of the time (and so are often joyful when menstruation begins), and conceals "the true unity women have    [Menstruation is] the one thing we all share" (p 112) In spite of ambivalence about the "disgusting mess," most interviewees felt that menstruation defines them as women and insisted that they wouldn't want to give it up Teens spoke of the joy of getting their periods so they could be part of the in-group that shared the women's "special secret," of mothers and sisters greeting their first menstruation with "You're a woman now! …

The Woman in the Body: A Cultural Analysis of Reproduction

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Death without weeping: the violence of everyday life in Brazil

The author has done a Herculean job of interviewing more than 1000 Japanese women over 20 years. The inquiries were to establish what knowledge these women had about the menopause and the symptoms they experienced. Women from all walks of life were included. Each chapter has a theme, and narratives from selected women are included to describe and emphasize the point being made. Statistics are detailed in one chapter, and the rest of the book is devoted to narrative description. A detailed picture of life in Japan evolves from this. Changes in society are well outlined, allowing one to better understand how the nuclear family is evolving and the problems that have resulted. Information is given about the position of various members of the family and the extended family. Emphasis is placed in this narrative on the role of women—their work habits and daily living experiences, particularly during the midlife

Encounters With Aging: Mythologies of Menopause in Japan and North America

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Testing Women Testing The Fetus The Social Impact Of Amniocentesis In America

Despite its commonality, there is a paucity of literature on miscarriage in non-Western societies. In particular, there is little understanding of how people ascribe cause to miscarriage. This research sought to gain an in-depth understanding of notions of miscarriage causality and risk amongst Qataris. The study adopted an exploratory descriptive qualitative approach and collected data during 18 months of ethnographic research in Qatar, including semi-structured interviews. The sample includes 60 primary participants (20 pregnant women and 40 women who had recently miscarried), and 55 secondary participants including family members, health care providers, religious scholars and traditional healers. Informed consent was obtained from all participants. Primary participants were interviewed in Arabic. The interviews were audio recorded, transcribed and translated into English. Data was analysed using an inductive thematic approach, which involved identification and application of multiple codes to different text segments. Data were encoded manually and examined for recurrences across the data set. Similar quotations were grouped into subcategories and further categorized into main themes. A number of key themes emerged, revealing Qatari women attributed miscarriages to a number of factors including: supernatural forces, such as God’s will and evil eye; lifestyle, such as physical activities and consuming particular substances; medical conditions, such as diabetes; and emotional state, such as stress, and emotional upset. Resting, avoiding stress and upset, maintaining healthy diet, and spiritual healing (ruqyah) are seen as a means to avoid miscarriage. Practices and beliefs around miscarriage are embedded in social, cultural, religious and medical frameworks. Understanding the socio-cultural context and understandings of explanatory theories can enhance health care providers’ understandings, resulting in improved communication and care.

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Causal explanations of miscarriage amongst Qataris

This article explores emerging themes from the first stage of
ethnographic research investigating pregnancy and loss in Qatar. Issues around
the development of foetal personhood, the medical management of the pregnant
body and the social role of the pregnant woman are explored. Findings suggest that
Qatari women are expected to be calm vessels for their growing baby and should
avoid certain foods and behaviours. These ideas of risk avoidance are linked to
indigenous knowledge around a mother’s influence on a child’s health and traits.
Motherhood holds a particularly important place in Qatari culture and in Islam,
and women are ultimately responsible for protecting and promoting fertility and
for producing healthy children.

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Calm Vessels: Cultural Expectations of Pregnant Women in Qatar

Following a miscarriage many women report feeling guilty and culpable for what has happened particularly when aspects of societal blame and stigma are involved. This research investigated the impact of cultural context on the experience of miscarriage. In particular, it focused on how elements of stigma and blame are linked to notions of miscarriage etiology and risk among Qatari women. The research used an ethnographic approach. The data was collected over 18 months of fieldwork in Qatar, using semi-structured face to face interviews, and participant observation. A purposive sample of 40 women (primary participants) who had recently miscarried, participated in the study. Potential subjects were initially identified in the Women’s Hospital and were consented, and then interviewed in Arabic either in the hospital or at their preferred location. The interviews were audio recorded, transcribed and translated into English. Additional key interviews were performed with 20 secondary participants related to the miscarriage cohort including family members and husbands. Inductive thematic analysis of content was performed manually to extract themes. Two main themes emerged from the material looking specifically at miscarriage aftermaths: rhetorics of blame, self-blame and feelings of guilt; and miscarriage attitudes. Overall society is sympathetic and miscarriage is seen as normal and not particularly worrying, but understood to be upsetting to women. However, findings suggest there is some ambivalence around blame, culpability and stigma applied to miscarriage; some participants perceived miscarriage as a relatively normal and common event, whereas, others felt that miscarriage is resounding stigma and shame. Miscarriage aftermaths are embedded in social, cultural and religious frameworks in relation to notions of risk and causation. Attention should be paid to ensure women and those around them are given appropriate and robust information about miscarriage causation to deflect discourses of blame that may be employed and reduce harm to women who suffer miscarriage.

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Culpability, blame, and stigma after pregnancy loss in Qatar

Background: Preeclampsia and eclampsia are two hypertensive disorders of pregnancy that significantly contribute to higher morbidity and mortality rates. Eclampsia is the occurrence of seizures in patients with preeclampsia without any previous history of seizure disorders. The incidence and prevalence of eclampsia varies, and there is scarce literature about the prevalence and trends of eclampsia in the Arabian Gulf countries. This study aimed to identify the incidence and changing trends of eclampsia in Qatar. Patients and Methods: This retrospective study was conducted at Hamad Medical Corporation, the only tertiary heathcare center in Qatar, and included all patients admitted with eclampsia from 1979 to 2017. The demographic data, maternal age, parity, gestational age, antenatal visits, timing of seizures, mode of delivery, treatment, maternal morbidity, and mortality were recorded. The study period was divided into the initial period of 1979–1988, 1991–2009, and the recent period of 2010–2017. Data analysis was performed using chi-square tests to identify trends among the three different periods. A p value of ≤ 0.05 (two-tailed) was considered statistically significant. Results: A total of 151 patients with eclampsia were admitted with an increasing incidence of eclampsia over time. There was a statistically significant improvement in antenatal follow-up and an increase in the maternal age of patients with eclampsia (p = 0.001). The incidence of eclampsia without proteinuria increased significantly over time (p = 0.03). Postpartum eclampsia was more common (p = 0.002). Labetalol was the most frequently used antihypertensive agent (p = 0.001), and magnesium sulfate has been increasingly used as an anticonvulsant agent (p = 0.001). The rate of maternal morbidity was decreasing, and in the recent period, posterior reversible encephalopathy syndrome was becoming a common comorbidity in patients with eclampsia. Maternal mortality displayed significant improvement, reaching 0% in the recent study period (p = 0.02). Perinatal mortality likewise displayed a decreasing trend and reached 3.17% in the recent period. Conclusion: The incidence of eclampsia is increasing in Qatar. The antenatal care of patients with eclampsia has improved significantly. The medical management of patients with eclampsia has also drastically improved, leading to a significant decrease in maternal mortality and improvement in perinatal outcomes.

Changes in trends and outcomes of eclampsia: a success story from Qatar.

This paper explores the emergent themes from the first stage of our cross cultural research (UK and Qatar) into pregnancy and pregnancy loss. This paper presents a culturally grounded representation of pregnancy and the experience of pregnant women in Qatar. In order to understand the experience of miscarriage in Qatar, it is necessary to first develop an ethnotheory of pregnancy. This research uses the approach and methods of medical anthropology. However, this project is particularly exciting because of its commitment to interdisciplinary research: the research is informed and led by our collaboration between anthropologists and medical doctors. Ethnographic methods provide an in-depth understanding of the experience of pregnancy and pregnancy loss. Our main method is semi structured interviews, but true to our anthropological foundation, we are combining this with other forms of data collection. We are observing clinical encounters (doctors appointments, sonography sessions) and conducting participant ...

Halima Al Tamimi

Papers

Causal explanations of miscarriage amongst Qataris

Calm Vessels: Cultural Expectations of Pregnant Women in Qatar

Culpability, blame, and stigma after pregnancy loss in Qatar

Changes in trends and outcomes of eclampsia: a success story from Qatar.

Culture embodied: An anthropological investigation of pregnancy (and loss) in Qatar