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  • Доульское сопровождение родов: генезис, дискурсы и практики эмоциональной и физической немедицинской заботы

Article

Доульское сопровождение родов: генезис, дискурсы и практики эмоциональной и физической немедицинской заботы

Кукса Т. Л.

The article regards the prac­ tice of paid emotional, informational and physical assistance to women during pregnancy, childbirth and the postpartum period, as well as the Russian­speaking providers of these services: perinatal experts independent of obstetric institu­ tions, self­presenting themselves mainly as «professional», «partum», or «postpar­ tum» doulas. Using a neo­Weberian ap­ proach to (para)medical knowledge, jobs, and professions, the author illustrates influence of the state and market on the spread of non­medical emotional and physical care practices in the modern Russian maternity hospital.
Despite the informal status of non­med­ ical assistants and the associated risks, the educational and digital activism of the doula network leads to the con­ struction of special competence, stand­ ards, ethics, and language, but also to an increase in the number of «certified» doulas. Labor and educational mobility, family and digital everyday life of care agents with no official status involved in precarious and paid maternal self­em­ ployment also contribute to autonomous self­regulation of the community, recep­ tion and standardization of approaches, reassembling the boundaries of activity, local volunteering and popularization/ broadcasting of doula discourse.

The phenomena described in the article con­ tribute to an accelerated change in the entire medical landscape, biomedical knowledge and discourse towards fur­ ther humanization (mainly commercial) of modern obstetrics. In particular, the author records the emergence of pa­ tient­centered communication, informed coordination of medical interventions, partial demedicalization, taking into account evidence­based medicine data in new protocols and routine practices, expanding the agency of women in la­ bor when choosing participants, place, and method of delivery.

The research is based on a communicative analysis of discourses and narratives that have been collected since 2017 in the field ethnographic study of perinatal practic­ es and their representations in various contexts and sources. The database includes semi­structured in­depth inter­ views, information from social networks and media resources, and regulations.