Being Near Birth w/Andrea Ford

Show notes

In this episode, Élaina interviews medical and cultural anthropologist and practising birth doula, Andrea Ford. Andrea discusses her trajectory as an interdisciplinary scholar and the power of studying liminal spaces to better understand what different cultures value. 

CW: This episode contains discussion of fertility, pregnancy, and childbirth.

You can find out more about Andrea’s work here: https://andrealillyford.com/ and here https://www.research.ed.ac.uk/en/persons/andrea-ford

Texts mentioned in the episode (All links are affiliated to Bookshop.org UK and any purchases made through them will generate a small commission that helps to support the podcast):

Beyond Black, by Hilary Mantel

Subscribe to Philosophy Casting Call and leave it a 5-star review wherever you can!

Follow Philosophy Casting Call on Twitter and Instagram @philoCCpod

Read the full episode transcripts at www.elainagauthiermamaril.com

Support the podcast by becoming a monthly donor on Ko-Fi.com

Follow Élaina on Twitter @ElainaGMamaril

Transcript

Élaina Gauthier-Mamaril 0:14

Hello and welcome to Philosophy Casting Call, the podcast that features underrepresented philosophical talent. I’m Élaina Gauthier-Mamaril, your host and producer. In this episode, I offer you my conversation with my colleague Andrea Ford. Andrea is a medical and cultural anthropologist whose work currently focuses on menstrual health and hormones, but she is also writing a book on what she calls the “near birth” liminal space. As a trained and practising doula, Andrea has conducted years of field research on the Californian culture surrounding bringing a child into the world. This also means that this episode discusses pregnancy, fertility, and childbirth, so take that into consideration before you continue listening. Another note I want to make is that the term “crip doula” I reference in the interview was coined by crip ancestor Stacey Park Milburn who sadly passed away from medical neglect during the early months of the COVID-19 pandemic. Now, without further ado, here is my conversation with Andrea Ford.

Hi, Andrea, welcome. Thank you for being here.

Andrea Ford 1:31

Thank you so much for having me.

Élaina Gauthier-Mamaril 1:32

Would you like to introduce yourself to the listeners?

Andrea Ford 1:36

Sure. My name is Andrea Ford. I'm a medical and cultural anthropologist. I work at the University of Edinburgh. I'm from California. And a lot of the work that I do revolves around questions of health for women, although, as we might discuss in the podcast, I don't necessarily like the terms "women's health" and "reproductive".

Élaina Gauthier-Mamaril 1:56

Yeah, it's pretty complex, to say the least when we think about reproductive health in general. But I remember you told me you also were part of an interdisciplinary programme coming up. Can you say more about that?

Andrea Ford 2:10

Interdisciplinarity has been kind of constant, actually, in my intellectual background, I guess. So currently at the University of Edinburgh, I'm part of the Centre for Biomedicine, Self and Society, which is largely Science and Technology Studies, which is itself an interdisciplinary field. I guess that's subject to debate, but we've got historians, bioethicists, anthropologists, sociologists, and there's also artists and visiting clinical fellows. So there's a lot of people with different backgrounds kind of converging around how do health and society affect each other. I also did an interdisciplinary degree for my bachelor's, which was in Berkeley, I kind of invented the major and then did a master's in African Studies, which is also an interdisciplinary programme, and that was at the University of Ghana.

Élaina Gauthier-Mamaril 2:59

Wow, that is very interdisciplinary! My kind of scholar. But how would you now, when you reflect upon it and your own practice over the years, how would you define interdisciplinarity as it works within your scholarship?

Andrea Ford 3:14

I think, for myself, it has simply meant following my curiosity, but if I were to define it at this point in my career, I would say it requires awareness of how you were trained, and open mindedness about other ways of producing or approaching knowledge. I think it requires a lot of humility. And like I said, curiosity, but also a fair amount of confidence because you have to not devalue your own perspectives and contributions. Although that can be quite tempting when you're surrounded by people who define good research or important subjects in ways that might be different than you.

Élaina Gauthier-Mamaril 3:57

And your work now at CBSS is partly involving endometriosis, and looking at the intersections between the healthcare aspects and healthcare research and your anthropological work, but you're also working on a book, documenting your ethnography around birth and what you call the microcosm that surrounds birth. And would you like to say more about that?

Andrea Ford 4:25

So my PhD research, which was quite a long undertaking, involved in this three years of fieldwork, during which I trained as a doula, so if you've not heard of a doula, it's a birth support person. So you're trained, but you're not a medical professional. So you don't have liability. And you have tend to have more of a perspective on the kind of emotional and physical needs of the person giving birth as opposed to but often ends up being technological readouts from the various monitoring devices. So anyway, that was an interesting way to do fieldwork. And I chose to do that because I mean, on the one hand, it allowed me to gain access to what I call "near birth spaces". So places where people are literally giving birth, but also beforehand, afterwards, I'm talking about birth while also contributing myself. So birth is a fairly intense experience. And people don't necessarily want someone just observing them. So I felt doing something useful in the situation would not only make it make sense to people that I was there and contribute something, but be really interesting as well. And I ended up just loving that type of work, you have to be really calm while there's a really intense situation happening and kind of people talk about holding space. And I enjoyed that a lot. So the book comes out of this long process of doctoral research. And what I do in it is look at how the tensions near birth are. Sometimes I say they're symptomatic, which is kind of a fancy word have to mean that they come from a bigger place where they're a microcosm, as you mentioned, which is a tiny world that is arranged in a similar way to the bigger world. So I look at these seven values, including like progress, equality, nature... Redemption, actually is the last one, which is kind of odd. And these are what I call values that are being worked out in society more broadly, like their conflicts, their questions, or something that's supposed to be good, but people don't actually know what that means, or it looks like in practice, and so when you are doing something like having a baby, which is bringing a new life into the world, it's this kind of liminal period and anthropologists talk a lot about how liminal periods are the transition state or the in between state where things become a bit loose and open for redefinition. So the values that are present more broadly in society, they be kind of the kind of become loose in a way they become something that people have conflict over or are struggling with, because they're full of contradictions. And we might not think about that in daily life when you're doing something like giving birth, and the contradictions can come to the floor.

Élaina Gauthier-Mamaril 7:07

Do you have any example?

Andrea Ford 7:09

The most obvious example is around individuality. So we tend to think of people as individuals with rights and responsibilities, but when you have a pregnant person, or as I like to think of it, anybody who's capable of becoming pregnant or an infant person, a foetal person, even a child kind of person and nursing person, this whole process, which I called "near birth", so that I'm not just focusing on a phase, which is kind of arbitrarily defined throughout this whole process, you have two people who are really dependent on one another, are really enmeshed with one another. And that's very tricky, because you don't certainly I don't want to go down the route of saying that one person is more important than the other or that someone shouldn't have the right to terminate a pregnancy, if that's not what they want in their life at that time. But at the same time, it doesn't fit very well, I guess, is the main point, the co-bodiment or dependence doesn't fit very well with how we think about rights and responsibilities.

Élaina Gauthier-Mamaril 8:10

Yeah, I have a bit of a personal experience with that. That probably is one of the reasons that motivated me to look into relational autonomy, relational agency in health care when my mother was pregnant with her fifth child, and there were complications at the birth, if she was with a midwife, there were complications with the baby, we moved to a hospital, then, you know, it was a difficult birth, the baby was a neonatal care. And my mother went into shock, basically, afterwards. And I was the one as the eldest child who could go visit the baby. And my father had to go to work. And then someone else, like a family friend came to take care of the other children. So you see, like already, all of the people involved within that. You know, you have, obviously in my mother, who was the pregnant person, but she was unable to mother according to her own values. Like for her, it's very important to breastfeed, they wouldn't tell her if she was allowed to with the meds she was on and that was creating a lot of anxiety. My baby sister was in neonatal care, obviously being cared for by nurses and visited by me. And then you had another woman or another like parent figure who was not related to us taking care of, so kind of a kinship care, of the other children who were too young. So just in that example, you can see how one child coming into the world like involves so many people.

Andrea Ford 9:38

Yeah, that's a really powerful example of how many people need to be involved. Another of the things the book talks about is equality and how this idea that equality is good, but how do you actually do that in practice and whose needs take precedence in a situation like that? How do you be equal partners if you have a partner when you're bringing a baby into the world? Are the siblings all supposed to be treated equally? I mean, it's really tricky to put values into practice when it comes down to it.

Élaina Gauthier-Mamaril 10:07

I read the introduction to your book, and one thing that struck me was your decision to lean in to the culture side of cultural anthropology, and resist the call of what you call "dark anthropology". And you pair that with this notion of culture for you is storytelling. So your choice of examining California or society in California, where you are from, as this decision to purposefully de-familiarise the familiar, as opposed to going to other countries. And maybe you can speak to this because you have done Africana Studies, you have been to Ghana, and then your decision maybe to do this field work in California as part of the American mythos. And why you decided to take your research in that direction, as opposed to doing a different methods of anthropology.

Andrea Ford 11:05

That's a great question with like four questions in it! I'll see what I can do. Yeah, so it was actually while I was studying in Ghana, and doing research there that I, on the one hand, became quite curious about what feels like home to me. I thought that going going to a place that was really unfamiliar to me, West Africa, made my familiar seem strange, which is this kind of quip about what anthropology is making the familiar strange and the strange familiar. So it was on one hand, really curious about it, it would become like a problem instead of something natural and taken for granted in my mind. And then there were also a lot of issues with the coloniality of anthropology and being a white person myself, doing research in Africa was complicated. And I don't take a stand on whether or not people should do that everyone will make their own way through the ethics of the colonial background of anthropology. But for me, it felt right to look at home as so I came into my PhD programme as an Africanist, and then switched midway to become an Americanist. So that was that and then about culture. So there, Sherry Ortner coined the term "dark anthropology", which she says was a turn since the 90s or so, to really focus on injustice, and all of the really horrible things going on in the world, which which is related to the colonial past of anthropology and in a lot of ways, maybe kind of attempting to grapple with it or atone for it to really call out how much damage has been done and how it's still echoes throughout the world. So that's, that's an important project, for sure. And I think that returning to a more I wouldn't call it a deep politicised view of culture. But maybe, I guess it is something not necessarily politicised. Because then I think that can inform politics. So I do have political stakes and political stakes in the book. But the analysis is around how the stories get told how that works. In practice, like stories are not just verbal, they're also when you make decisions. They're based on feelings, they're based on beliefs, they're based on things that you've seen other people do. And I consider all of these things to be to be storytelling, basically, that you navigate the world and the ways of making meaning within it through stories. And so that is not explicitly political. But thinking about how that happens, how that actually works. And how we can see it in process, I think is really potentially very important in making change in what seems like an increasingly polarised political environment.

Élaina Gauthier-Mamaril 13:58

Yeah, and I would argue that storytelling is political, because all the decisions about who tells the story, how do we tell the story? Are there any constraints about how we feel we're allowed to deliver our story?, etc, all of these things matter. And when you talk about kind of following the values that emerged through your research and your practice as a doula as opposed to kind of thinking theoretically about what are the core values of American society, you're like, these are the values that came up. They're not the only ones, they're not going to be universally agreed upon as the best ones to focus on. But these are the ones that came through throughout, as you say, three years of actual field work. And I was reminded of something I learned in my Intro to Philosophy class many years ago, which was, values are simultaneously completely subjective and completely objective in the sense that when you have a value, when you hold the value, you are taking a stance or you are making a choice about how to see the world and see your life and maybe kind of, as you say, like what is to be desired, right? What are the things that we desire. But at the same time, we're never really satisfied with being like, "Well, that's just my preference". We secretly are not so secretly want other people to buy in. So it's this tension between like, this is something that can be feel very personal, but at the same time, no one is satisfied with having a value that is purely 100% personal: we want other people to see "Yes! This is also something that we should aim for, that we should organise and structure society to as a goal towards which we want to move as a group."

Andrea Ford 15:54

Absolutely. No desires happen in a vacuum. Like, in the research, what kind of emerged as a dogma, if you will, so there's, for those who haven't been near birth, there's a lot of tension around supposedly "natural" or "medical" ways of approaching it, there's a historical tension between these sides maybe and what has really emerged in my fieldwork was that whatever the woman wants, is what should happen. Like that was the kind of best position that was supposed to take a middle ground between this, of course, it doesn't actually work in practice very well, even though that would be nice. But even if it were to work in practice, what people want, as I say, isn't coming from a vacuum that comes from what surrounds them, the kind of cultural stories and a value can be interpreted in so many different ways. So even if it is something shared, like a value on autonomy, or quality, how that translates into your personal choices will vary really widely for people, it can be really challenging as an as an individual person who makes choices in the world to try and think about where my desires are actually coming from where they're being shaped by it can feel really disorienting, because we're sort of taught that that's the centre, maybe like that your that your own authenticity is something that can be relied upon. And when you start seeing it as contingent on what surrounds you, that can be really disorienting. On the other hand, it can kind of provide context that can help in other ways, what you said really resonates with me, and these are issues I'm thinking through all the time.

Élaina Gauthier-Mamaril 17:31

I go back to your use of the birthing process as a liminal space where we get to ask yourselves these difficult questions that, you know, maybe people won't have thought about until they're confronted with so many choices, as you say, like, Do you want a natural birth? Do you want it to be in a hospital? Do you want drugs? Do you want no drugs? Do you want, you know, the peaceful birth allowing no screaming? Do you want to have your partner present? Do you want to keep that separate? Like all of these things, and even once a child is there, let's say one of the options is you keep the child and then you're like, well, do you join like a mother-baby group? Are you part of all these other cultural things that happen, these expectations, and there's a lot of judgement about the right way to rear a child. So you're kind of propulse into this world, of constantly having to have an answer, and a rationale for the decisions that you're making with your child. And that I'm sure that must be overwhelming.

Andrea Ford 18:33

The judgement thing is huge in your birth spaces, and filters into so many different aspects that you might not have even thought about before you were put into these spaces, like a parenting centre that I kind of follow offers classes called "Non Toxic Baby". So it's just paying attention to all the potential toxins in your home environment, which have always been there. But you sort of feel newly judged, you feel newly responsible, you feel newly vulnerable, as a new parent and all these, it's like putting on new new glasses, and you see the world in a really different way. And this is reinforced by the social narratives that there's a class for this, you should be concerned about plastics, which are everywhere. And that doubles down on kind of anxiety, which then propels new parents to seek external kind of validation and external guidance. And the reason that there is well, I guess, I think there's several reasons I think, this liminal space where there's a new beginning, and reproduction is both a continuity and a new beginning. So I think it's quite an interesting place to look at how cultural values change. So So that's happening, that there's just kind of an inherent opportunity, but then there's all these cultural stories that are very gendered around women's specifically responsibility for the well illness of their child, which is super judgmental involves lots of blame and shame and unfair attribution of responsibility, especially when people aren't provided with the resources that they might need in order to make the choices that they would want if they weren't able. So there's a whole gendered set of stories, if you will, that complicate this, especially.

Élaina Gauthier-Mamaril 20:23

As we philosophers would call it: a paradigm, a hermeneutic grid. But yeah, it makes me think of my own research looking into crip doulas a term. I don't know if it was coined, but definitely used by Leah-Lakshmi Piepzna-Samarashinha, and "crip academic doulas" used by Hannah Facknitz and the Danielle Lorenz, this idea of having people who've gone through a similar process also usher other people into a new phase of their life or kind of lead them through this liminal space, basically, as elders. And so when I think of my friend, who has a lot of anxiety, and now she's had two children and had really positive experiences with a doula, is considering training as a doula herself, because it's this kind of reproduction, as you say, of like the the care process, and she sees like, "Yeah, this is something that I can do as far as like, I've been through it. And I have experimented with like asking for specific kinds of support. And I feel like I can be that for some one else". And when you look at it in a disability space, not even touching the reproductive area of disability studies, but even just this idea of how do we come together to discuss like, what are the values that we want to have as disabled people in the world? How do we help each other navigate this?, and I think it might be interesting to look into crip doulas, but also queer doulas, and this idea of, I mean, mainstream pop culture, with the advent of RuPaul's Drag Race and things, we're maybe made more aware of the idea of mothering within queen culture. And this idea of having families where you introduce someone else and you like, raise them as a baby queen, basically. And that largely comes also from the African American community. I know that this happens in African American trans communities and it's not necessarily the case in white American trans communities. There's different cultural things, but I think there might be something there to think about what does reproduction of care look like outside of these gendered norms?

Andrea Ford 22:45

Definitely. I didn't know about some of the uses of doula that you mentioned. I've heard of abortion doulas and death doulas and HIV doulas, and I think it's this relatively new term, I mean, the term comes from Greek and means "female slave", which is a little dodgy. But in the in the English lexicon, it's a relatively new term. And you can see it as you've shared being used in ways similar to how people might have used midwife or mother. But when you get a new term, you get new possibilities that come along with it, as you say, that are that are less gendered or less rigidly gendered, then then maybe midwife or mother might have been and having a mentor, just another possible word, I guess, to bring you into a new space or help someone through a transition. think is super valuable. However, that will look really different. As you're saying to different communities, different cultures, what kind of kinship is recognised? What kind of expertise is recognised? These are really fascinating questions. Something that I wouldn't necessarily say struggled with, but encountered in my fieldwork was the fact that I haven't given birth or ever been pregnant. So sometimes it would be like, well, how can you be a doula if you've never gone through this? And that's a valid question. On the other hand, not having experienced it personally creates a kind of openness so that you can really meet someone with what's happening for them without bringing your own personal... I don't love the term "baggage", but like your own past experiences or your own things that you need to process in order to show up for somebody else, because the way that they go through it will be different than what would have happened for you. So there's so there's benefits to both.

Élaina Gauthier-Mamaril 24:33

I also think that there is something generative to the idea of being a witness as well, like as you say that I don't think we always need to exactly have the same experience as someone else in order to engage in care work and to participate. And one of the things you wrote in your introduction was also that a reason to move away from a kind of gendered language. inch around being near birth is also to tackle the binary male female opposition where men feel like they can't relate to the birth process or that yeah, this is a space that does not include them and therefore needs extra navigation. And I think we have to be aware and cognizant of the fact that sis men not being able to bear children also has a huge impact on how they are involved in the sense that, for example, I'm not going to advocate that men should be deciding what women should be doing with their bodies by claiming some kind of equality. But I think it is interesting. If we kind of reject the idea that they're completely two different spheres, then how do we engage men in care work surrounding me or birth? And how that can be generative in terms of upholding some of these values that you've identified?

Andrea Ford 26:03

That's a great question that the equality chapter, again, really is where I try to think through some of this and how you enable someone to take responsibility without handing over too much control is an interesting question. It's something that people work out on their, in their in their particular ways. Certainly, I think there are lots of people involved in reproduction. And their responsibilities might vary quite widely, but having a conversation about what those responsibilities are is super important, I think. And I mean, the decision that I think you're referencing in the introduction was about using non gendered language like pregnant person, as my kind of default. And I think that although sis men can't be pregnant and bearing children has been a really central, the way that society treats bearing children has been a really central problem for a lot of sis women's feminism. But instead of focusing on this as a woman's issue, making it a social issue, a people's issue, I think, opens the door for different kinds of responsibility to be taken. And I won't say what that should or shouldn't look like, but having that conversation about how do we all contribute to the reproduction of our society? And what do we owe as well to people who are doing other components of that that reproductive work should be a conversation that takes into account people's different bodies and different inclinations, but also is not gendered in a in a predetermined way?

Élaina Gauthier-Mamaril 27:46

And as we close out here, do you want to talk briefly about your current work and what you hope to do with your future work at CBSS and beyond?

Andrea Ford 27:55

Sure. So I've been working on a project, I guess, like the kind of through line has been hormones, which I think are totally fascinating. So hormones figure largely into birth and birthing spaces. There's kind of a new discourse that bridges, older natural birth ideas and more kind of medical ways of reasoning that talks about hormones and how you create an environment that is conducive to certain kinds of hormones, and not others. I found it fascinating in my birth research, and then was really interested in questions of endocrine disruption, which is just when environmental chemicals change how hormones function in your body. So this is often called like toxicity or pollution. But in any case, it's changes that you didn't anticipate. And that led to me looking into hormonal disorders, and menstrual disorders, specifically endometriosis, which is classified in a bunch of different ways. And that's what I'm looking at right now. How is it classified? And what impact does that have? So is it a hormonal disorder? Is it a a period disorder? Is it a women's condition? Do you call it a woman's condition, similarly to childbirth that highlights a certain kind of oppression, if you will, or historical ways women's conditions have been under researched and under invested in, but it also like, marks it as this niche topic and kind of perpetuates that? So anyway, that's that's a question. Is it a reproductive issue? There's lots of inflammatory mechanisms is an inflammatory issue, should we actually think about it as a set of symptoms instead of a disease? Anyway, these are all questions that I'm working with right now. And then hope to expand from here into looking at menstrual health more broadly. So thinking not with women's health or reproductive health, which as I mentioned at the beginning, are these terms that I find tricky because they reinforce these ideas about who does reproduction and what women's bodies are primarily for, but rather with something like men straw health so bodies that men straight have certain capacities and, and certain care needs. And that renaming it might help us think about it differently, which might affect some social change.

Élaina Gauthier-Mamaril 30:12

Yeah, that's really interesting when I think about my friends in the disability community, so who identify as disabled and have endometriosis, and sometimes with other disabilities, sometimes not. I mean, some of them are yes are concerned about fertility and things like that, but some of them aren't. And their experience of endometriosis is not a reproductive issue, per se. So I think that really resonates this idea of like menstrual health. And, you know, this is a part of a body and it has certain needs, but it's not necessarily with in the framework or the lens of reproduction.

Andrea Ford 30:47

Yeah, totally.

Élaina Gauthier-Mamaril 30:48

Do you have anything that you want me to put in the show notes, things that people can read about either your own work or things you want to point people to?

Andrea Ford 30:57

I'd be happy to give you my website, which has links to some of the things I've written. And then the CBSs blog has some good stuff on it. And hopefully, we'll have more including your own work.

Élaina Gauthier-Mamaril 31:08

And I always ask before we leave, are you reading or watching or listening to anything that is giving you life right now?

Andrea Ford 31:16

That's a really good question. I'm taken a bit off guard! What I'm reading right now, I just finished a book by Hilary Mantel who says, a historical fiction author, best known for Wolf Hall, which is kind of about Henry the Eighth. But this is a book that's called Beyond Black. And it is about the kind of one person's experience with death and the supernatural, I suppose. I love the way that Hilary Mantel brings you into another person's perspective without packaging it up too much. It's just like seeing the world through a different set of eyes, which I think is what really good fiction can do. And hopefully, like good anthropology can do.

Élaina Gauthier-Mamaril 31:59

Well, thank you so much for coming on the podcast and good luck with the rest of your research!

Andrea Ford 32:04

Thank you so much, and talk to you later.

Élaina Gauthier-Mamaril 32:16

Thank you Andrea for your time and expertise. It definitely has given me much to think about and I look forward to reading your book! As always, I will link Andrea’s website in the show notes if you would like to find out more about her work. If you want to support Philosophy Casting Call, the best way is to rate the podcast and to leave a review on Apple Podcasts or Spotify. Also tell me if you use Philosophy Casting Call in your classrooms, cause I would love to know! If you are in a position to donate, you can also become a monthly supporter on Ko-Fi.com You can follow the podcast @philoccpod on Twitter and Instagram and all the transcripts live on my website at www.elainagauthiermamaril.com. Until next time, bye!

Transcribed by https://otter.ai