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Retail therapy in an antenatal clinic: the construction of raced, gendered and classed pregnancy.

Date Released: Mon, 11 August 2014 11:34 +0200

When I watch the shopping channel on television I know on a rational level that it is going to take a lot more than razor-sharp knives or a magic mop to turn me into a domestic goddess.  But I’d be lying if I did not admit that sometimes I desperately want to believe that I am one purchase away from a radical transformation.  The false hope offered by retail therapy is seductive and often stronger than the feeling of buyer’s remorse which inevitably follows soon after the purchase.

Recently, despite not being pregnant, I have been spending a lot of time in the waiting room of a public antenatal clinic. There I observed a retail therapy of a different kind.  A sales representative (from one or other baby-care product company) would arrive in the hot and stuffy waiting room wearing a branded pink satin sash and wheeling a big suitcase. I was not sure if she reminded me more of a beauty queen (the sash) or an air-hostess (the suitcase). I imagine that even if she did not arrive to the sounds of an angel choir and wasn’t seemingly surrounded by a pool of light she would still have provided welcome relief from the boredom of waiting in that queue.

I witnessed a variety of different sales presentations over the next few months.  Each one started in the same way with a brief lecture on a topic presumed to be of interest to pregnant women.  The sales representative was a veritable mine of psychologised information about pregnancy and baby-care and her prescriptions for best practice went unchallenged.  Women nodded politely as they were implored by the salesperson to make eye-contact with their babies for the purposes of bonding. No one questioned her recommendation to exercise regularly even when pregnant women arrived at the clinic hot and exhausted from having walked long distances. In a manner not unlike the television salesperson, the attention of the audience was kept with the promise of a reward as in “But wait!  There is more …”

The reward for being attentive and patient came in the form of a goodie bag.  But before these free gifts were distributed every woman was expected to provide her contact details for the purposes of ‘customer care’.  As anyone who has ever provided a market researcher with contact details knows this form of care most often comes via unwarranted notifications of not-to-be-missed special offers. The construction of a so-called caring relationship with the consumer masks the strategically managed creation of easy access to the consumer database.

The distribution of goodie bags was strictly monitored to ensure that each customer received only one.  Evidence of receipt was carefully monitored by the sales representative who placed a promotional sticker on the maternity case folder of each lucky beneficiary.  A goodie bag contained one disposable nappy, twelve wet-wipes and two promotional booklets.  Both booklets were glossy full-colour publications aimed at providing information about pregnancy and parenting.  Representations of attractive, middle-class, heterosexual nuclear families beamed from every page. In keeping with contemporary discourses about shared parenting responsibilities fathers were portrayed as bathing and playing with their babies whilst mothers were most often depicted as feeding, comforting or putting the baby to sleep.   

Why should these raced, gendered and classed social constructions of pregnancy and parenthood matter to all of us?  There are many reasons but the most obvious is that such limited and stereotypical representations work to distract us.  Not only do they conveniently exclude particular kinds of women as illegitimate recipients of healthcare but in doing so they also divert our attention away from the problematic social and institutional context in which antenatal services are delivered. 

What some might call harmless advertising functions to construct the idealised norm of pregnancy and parenthood. The prevalence of these picture-perfect pregnant women and families functioned as an unspoken and aspirational template.  By implication many alternative but common-place representations of pregnancy and family life (such as much older or much younger pregnant women, single-parent or working-class families, same-gendered parents and parents or babies living with disabilities) which might populate our lived experiences are simply denied.

Erasure in the symbolic world (such as on the pages of a promotional booklet) translates very easily to exclusion in the real world.  If we do not deconstruct the symbolic erasure of particular kinds of women we are more likely to use their very absence as justification for further exclusion.  For example, instead of asking why the antenatal clinic of the public health facility is not wheel-chair friendly it becomes easier to ask why a disabled woman is having a baby.  When someone, who does not fulfil the criteria for being considered a legitimate subject for antenatal health care, is excluded, it is easier to question their presumption of such a right than to deconstruct the circumstances which lead to their rights being denied.

When we focus on the individual our attention can be diverted from the inadequacies of the state health system. The attention is diverted from the fact that some public healthcare facilities are so over-crowded and under-resourced that basic standards of service delivery cannot be maintained. Instead of focussing on the difficult and complex issue of why the clinic has run out of contraceptives (again) the young women requesting contraceptives can be used as a scapegoat to reduce and simplify the issue to that of an individual moral problem. By individualising social issues and pathologising particular kinds of women their exclusion can be justified in a way that the structural or systemic inequalities and shortcomings cannot.

The presence of the sales representative and the distribution of goodie bags function as a persuasive advertorial. The baby-care products are being sold as new (and improved!) socially acceptable ways to be a pregnant woman or a mom in the guise of education.  The “helpline” given to the women in the booklet is actually a customer-service telephone number.  Help with regard to pregnancy or parenting is strictly limited to information about products.  In practice this means unless you are a consumer, you cannot be helped.  The “right to health” as promised to the women from the posters on the walls in the waiting room have become collapsed with “the right to buy health” from an always ready salesperson.

Personally, I found this conspicuous display of crass consumerism in an environment of scare resources, distasteful.  But I needn’t have worried. The women sitting in the waiting room were not fooled.  The sales representative had scarcely wheeled her suitcase of goodies out of the waiting room when the women were skilfully removing the promotional stickers from their case files.  They knew that the sales representative would be back soon to demonstrate, in earnest, why nine baby-care products are essential for bathing a baby.  And when she did so they would be willing to play the requisite role of compliant consumers again since one nappy and a few wet wipes are not much good to anyone.

Source:Tracey Feltham-King