Centre for Cultures of Reproduction, Technologies and Health

A Crisis Of (Feminist) Faith Through An Encounter In A Clinical Setting

CORTH Blog: 2 June 2020

Written by CORTH member Sreeparna Chattopadhyay as part of a series published by Anthrodendum on trauma and resilience during fieldwork. https://anthrodendum.org/author/trauma-and-resilience/  July 1 2019

Sreeparna Chattopadhyay is a Senior Research Scientist and Associate Professor at the Public Health Foundation of India and her research areas are in gender, health and, family and the law in India.

A Crisis Of (Feminist) Faith Through An Encounter In A Clinical SettingIntroduction

In the last ten years since I graduated with my doctoral degree, I have conducted research in both clinical and conventional anthropological settings. My doctoral work examined domestic violence in Mumbai, India. My work since then has focused on health and sexual violence, with considerable periods of observation in hospital settings. My experiences tell me that while both types of project have the potential to inflict trauma on the anthropologist, their nature is different. In clinical settings, non-clinicians when witnessing clinical ‘acts’, loosely defined as surgeries and other invasive procedures, may be shocked and even traumatized by these, never having had exposure to such interventions. However, not all clinical acts are equally traumatic. Here, I offer examples of a third-trimester abortion contrasting it with a cesarean section of live twins, both of which I witnessed, to argue that whether procedures are viewed as being traumatic are contingent on the meanings that those acts embody, for us as anthropologists and for the individual undergoing these procedures.

Not all surgical incisions are the same

One winter morning in 2015, in a remote part of northeastern India, close to the border with Bangladesh, my research assistant and I were hanging out in a government hospital. I had just begun a study, the second stint of fieldwork after my Ph.D. on maternal health in the region. We had entered the pre-labor room which was comprised of ten beds, only two of which were occupied that day. We were speaking to one of the women, who was being transfused prior to her induction, about how she managed anemia in a region where 90% of women become pregnant with moderate levels of anemia.

Within what seemed like seconds, but must have been longer, there was a flurry of activities and the doctor was instructing all visitors to clear out the room. A curtain was quickly drawn around the bed of the second woman, whose name we later discovered was Anita [1]. She was accompanied by her mother, her fifteen-month-old daughter and a health worker. As we were wondering if we should leave too, the smell of blood hit my nose. A minute later, I saw the doctor walk across the room holding a bloody sac that left bright red spots on the cement floor. Soon after, Anita was wheeled into the Operation Theatre.

In the afternoon when we returned to the recovery room, Anita laid on the bed clutching her knees to her chest, her green skirt bloodied, face twisted with pain. I asked her mother whether she had a boy or a girl. I was wrong – it was a medical termination of pregnancy (MTP) at 7 months. My shock soon gave way to sadness and anger. A medical termination of pregnancy at 7 months is illegal in India. Besides, we now have the technology that ensures that a fetus is viable outside the womb at 7 months.

I discovered that Anita was an indigenous woman who lived forty kilometers from this facility. She had not known that she was pregnant until she was in her fifth month, because she was still breastfeeding her older daughter. It took her another two months to gather the resources to make this trip using three different modes of transport. She did not have enough money to bring up two children and had decided to end this pregnancy. The doctor and the health worker had counselled her on the possible harms, but she insisted on the MTP. She returned home that same evening with antibiotics and analgesics.

About four years later, in the early summer of 2019, in Karnataka in Southern India, I had front row seats to a pair of twins being delivered through an emergency Cesarean section. In a busy state facility, a very competent Ob/Gyn allowed me to accompany her into the OT as she performed the complex procedure. I saw the scalpel draw blood. She used scissors to widen the cut just above the woman’s pubic bone, standing on a stool to reach deep into the woman’s uterus as one of the twins was stuck below her rib cage with a cord tied around his neck. He was extracted first, while his sister was taken out a few minutes later, crying lustily as she tasted her first breath of air.

This was the first C-section or any operative procedure that I had seen. This was a far bloodier encounter than the MTP I had partially borne witness to. Yet the meanings that these acts embodied could not be more different. It was not the blood and gore of the clinical procedure itself that left its long shadow on me, but what it meant for me as a feminist and a woman who cannot bear her own children.

A crisis of (feminist) faith

When I remember that day in the winter of 2015, I remember pacing anxiously in my small cold room at the missionary boarding house, my home for the duration of the fieldwork. I remember having a fitful night, in fact several unsettled nights where sleep was punctuated with nightmares of children shrieking and worms splitting my skin to emerge like alien births.

As a feminist who is committed to pro-choice, but simultaneously unable to bear children and has yearned for motherhood for years, this encounter was emotionally traumatic, intellectually disruptive, and morally unsettling for me. While my immediate response was affective – grief, guilt, anger and fear – in subsequent processing of this encounter, I experienced an intellectual crisis which itself was deeply traumatic.

I knew that Anita had all the “risk” factors, for landing in this medically dangerous situation – she was poor, indigenous, lived in a remote, hilly part in a disadvantaged Indian state. Yet I oscillated between feeling that she “chose” what was right for herself and grieving the loss of a potential life. Anita went against medical advice and the advice of two family members in choosing to have a late-term abortion

I felt embittered and puzzled.  Why hadn’t she considered giving birth and then giving up the baby for adoption? I would have willingly adopted this baby and, as a recent adoptive parent, I know that the queue for legal adoption is long in India.

The feminist in me chided myself for thinking of Anita as a mere reproductive vessel. I knew intellectually that only she had autonomy over her body. Yes, the termination was medically risky, but so are many other medical procedures. Yet patients choose them, weighing the benefits and risks of such procedures. What was different here? Perhaps when it comes to late-term abortions, I was flexible with my feminist ethics? Perhaps my inability to bear children was clouding the intellectual apparatus required for feminist praxis? Worst of all, perhaps I was not a feminist at all?

The Return of the Prodigal Feminist

These doubts continued to plague me for a while. A year later, I chose to write a case study on ethics about Anita and the attendant ethical, moral and intellectual conundrums it presented. I also discussed my experience and responses with my friends, family and colleagues. As I unburdened myself through speech and text, the shame chipped away, and the edges of my guilt felt a little less jagged. The existential angst I had experienced, unsure of my identity as a feminist, had settled a bit by then.

With time, I choose to see things differently. My feminist self and the mother in me didn’t have to be like Sophie’s Choice – I could be both, and still grieve this death. Strathern famously said that anthropology and feminism make for strange bedfellows, an “awkward relationship.” But feminism gifted me a lens and a language which was not burdened by ideas of cultural relativism or individual versus collective rights.

Porter, in moving away from a rights-based discourse on abortion in a very divisive Ireland, draws out similarities between pro-life and pro-choice activists and argues that both sides “…advocate responsible sex, good parenting, and caring communities.” Thus, abortion moves away from being a strictly medical procedure or a rights-based claims to a social and moral issue, where nurturance is the bedrock on which women take these decisions, and never lightly.

Although, for Anita, this abortion was not a choice in a real sense.  She had it to give her young daughter a better life. In a country where female fetuses are routinely aborted due to a cultural preference for sons, perhaps Anita should, in fact, be be lauded for her actions?

The affective dissonance that this incident elicited in me, though unsettling, was ultimately productive. Hemmings (2012: 151) writes, “Challenging the status of the expert, considering the shared epistemic claims from below, thinking outside one’s own initial investment in the desire for clearer and more accountable knowledge; these are all the features of an affectively attentive epistemology that allows for the transformation of all participants in the research field as well as knowledge itself.” I may never do what Anita did or had to, but Hemmings argues that empathy is not a prerequisite for building affective solidarity since it requires a departure from an identity-based politics. Ethical concerns demand that we do not judge choices based on similarities between us and the doer.

I don’t know how Anita will process her experience later. For me, while nothing is settled, this experience forced a reckoning of my feminist self. The questions continue.

For Further Reading

  1. Nordstrom, Carolyn, and Antonius CGM Robben .1995. Fieldwork under Fire: Contemporary Studies of Violence and Survival. Univ of California Press.
  2. Leibing, Annette, and Athena McLean. 2007. “Learn to Value Your Shadow!” An Introduction to the Margins of Fieldwork. The Shadow Side of Fieldwork: Exploring the Blurred Borders between Ethnography and Life: 1–28.
  3. Hemmings, Clare. “Affective solidarity: Feminist reflexivity and political transformation.” Feminist Theory13, no. 2 (2012): 147-161.
  4. Porter, Elisabeth. “Culture, community and responsibilities: abortion in Ireland.” Sociology30, no. 2 (1996): 279-298.
  5. Strathern, Marilyn. “An awkward relationship: The case of feminism and anthropology.” Signs: Journal of Women in Culture and Society12, no. 2 (1987): 276-292.

[1] All names have been changed to protect identities and the precise location of the hospital has not been shared since what we witnessed was not only dangerous but also an illegal act.