Too Much of a Good Thing? American Midwives and the Positive Side of Strategic Ignorance

• In Event: 132 - Section on Science, Knowledge and Technology Paper Session. Topics in Science, Knowledge and Technology Studies

Abstract

Managing risk is an increasingly pervasive goal of modern societies (Beck 1992). In biomedicine, we treat risk of disease as an illness in itself – suitable for monitoring and intervention. In some cases, increased monitoring and diagnostics improves patient health outcomes by detecting problems early and providing treatment. Recently, however, STS scholars and medical practitioners have noted that the diagnosis and treatment of risk can also lead to unnecessary medical intervention and possible harm (Aronowitz 2007). Childbirth in the U.S. serves as an illuminating case because it is one of the few areas where we can see these two models of health risk operating simultaneously. In addition to the usually dominant model of risk which values early testing, monitoring, and intervention, there is another well-entrenched and competing discourse, voiced mostly by midwives, that seeks to mitigate risk by refusing medical surveillance. Based on an archival analysis of professional documents and interviews with birth providers, this paper uses the case of fetal heart rate monitoring in obstetrics to highlight how strategic ignorance is used as a morally justifiable way to mitigate risk. Studying the success and limitations of this risk counterculture illuminates how modern risk societies are changing in response to data suggesting that more information can have hurtful effects.

Author

• Kellie Owens, Northwestern University