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RN16_01c_H: Neoliberalism and Challenges to Medical Professionals I
2:00pm - 3:30pm
Session Chair: Ekaterina Borozdina, European University at St.Petersburg Session Chair: Anna A. Temkina, European University at St.Petersburg
Location:HA.1.3 HAROKOPIO University
70 El. Venizelou Street
17671 Athens, Greece
Building: A, Level: 1.
Papers in this session will concentrate on health policies for people with disabilities with a specific focus on autism spectrum disorder, in comparative perspective, at a local, national and international level. It is organised in collaboration with the editors of the Scandinavian Journal of Disability Research in order to foster European debate on autism policy.
Economic Crisis and International Mobility of European and non-European health workers in the South-East of France: Citizenship and Gender
CNRS, Université de Nice Sophia Antipolis, France
The present contribution aims to analyze the geographical and social mobility of European and extra-European nurses in the South-East of France (PACA) in the context of the global social and economic crisis.
If, on the one hand, the economic crisis that affects Europe has led to the strengthening of control over Europe's borders, to limit “irregular” migration, on the other hand we also observe increasing “elite” migration trends. In order to better reveal the process and the dynamics shaping these latter mobilities, I propose a comparative analysis of professional and geographical mobility of intra- and extra-European migrants (men and women) in the health sector, characterized by an increasing shortage, a strong feminization and an increasing international and geographical mobility since the beginning of the 2000s. Besides, as a matter of fact, the integration into the European Union area of new Eastern European countries (with the automatic recognition of qualifications and degrees) has produced a competition between Europeans and non-Europeans in the French health labor market. This has happened despite the historic links that France maintains with African countries – the Maghreb and the former colonies of sub-Saharan Africa. Thus, there would be a new hierarchy of health professionals and a reconfiguration of the access to this employment sector according to citizenship, but also gender. Furthermore, analyzing the international mobility of these professionals means also to understand the balance between northern and southern countries in a context of globalization and economic crisis and the intenational process of health inequalities reproduction.
Doctors and midwifes between market, profession and personalized care (commercial childbirth care in Russia)
Anna A. Temkina
European University at St.Petersburg, Russian Federation
Different research shows the lack of trust to medical institutions and social roles of obstetricians in Russia. Some urban educated women as responsible mothers and consumers choose to pay for the childbirth care. The market in Russian health care has been developing since the 1990s, and expanded in the 2010es. Based on 14 in-depth interviews with medical professionals who work in hozraschetnye (paid) departments in state maternity hospitals I argue that medical workers redefine themselves as professionals in relation to market. Doctors and midwifes are motivated to work with paid patients by material benefits, though they make efforts to create boundaries between market and profession. They negatively evaluate market rhetoric of the patients and profit oriented colleagues, try to reduce financial issues to the brackets of interactions, which change the conditions of work and care, but should not colonize the professional world. They stress that medical treatment does not depend on payment (though somehow it does). Doctors and midwifes do not consider the commercial system as just one, but they should adapt themselves to it.
Doctors report that in commercial care they work more autonomously and take more responsibility to compare with regular department’s work. They work in more stable and reliable teams. They report about more “human relations” and personalized care, and they appreciate personalization of women as making process more satisfactory for both sides. Consumer’s choice is bracketing the interaction of women as patients and professionals in their social roles, and also slightly change professional conditions of obstetricians’ work towards more autonomous and satisfactory.
Freezing time: the hybrid strategy of promoting oocyte vitrification in Bulgaria
Ina Dimitrova Dimitrova
Plovdiv University Paisii Hilendarski, Bulgaria
The aim of the paper is to illuminate and explore the set of frames, constructed and mobilized around the so-called “social” egg freezing in Bulgaria. It argues that these frames combine in a curious way two opposing ideologies – a neoliberal and a conservative set of values, messages and images – which together form a heterogeneous discourse, which could be called “reactionary techno-progressivism”. Relying on a hybrid cultural texture, combining the still typical Bulgarian high valorization of parenthood (and especially motherhood), the demographic gloom haunting the country, and the ever popular postsocialist transitional neoliberal rhetoric, focusing on the need to praise the productive citizens, a contentious interpretative work is unfolding. It constructs women (and more generally draws the line between the “feminine” and the “masculine”) as active, productive, aspiring employees and leaders. This image, however, is obviously considered as incomplete in order to resonate with the specificities of the local context: it is stressed that something is lurking behind – the age old feminine nature, predestined to bear children and give birth. The “responsible” woman should recognize her “authentic” way of being, which the modern lifestyle has veiled, and reunite with it with the help of the most progressive means available – the new biotechnologies.
Introducing ‘natural’ childbirth in Russian hospitals: midwives’ institutional work
European University at St.Petersburg, Russian Federation
Since 1990’s Russian maternity care is undergoing a series of reforms associated with introduction of the neoliberal logic in work of the post-Soviet health system. While causing public debates, these reforms also become the subject of sociological research. However, there remain certain gaps in our understanding of these changes. First, the emphasis in studies is usually put on doctors, as if it is the only professional group that exists in healthcare and is affected by the transformations. Second, health care professionals are usually described as ‘victims’ of the reforms. New opportunities for agency that professionals acquire in the context of marketization and liberalization of Russian healthcare are rarely considered.
In this paper I intend to fill these gaps. I employ a concept of institutional work to investigate the experiences of Russian midwives as they engage in developing their professional project and changing maternity healthcare in the country. Using qualitative interviews collected at one of Russian centers for midwifery care, I consider midwives as agents, who struggle for professional autonomy and market niche in the volatile circumstances of healthcare commercialization. I concentrate on the two main points: 1) how midwives create new institutional space for ‘natural’ childbirth in Russian maternity care and provide new identities for those involved in this practice, 2) how the peculiarities of organization of Russian maternity care and state politics in the sphere determine the very form that ‘natural’ childbirth takes in the country.