Fear, gratitude, and the normalization of obstetric violence in Cuban maternity hospitals

Abstract

Obstetric violence is endemic in Cuba, a highly medicalized society where the obstetrics institution is unquestioned and, in the afterlives of Atlantic slavery and US occupation and intervention, emotions of fear and gratitude work to normalize obstetric violence and control birthing bodies for the state. I draw on ethnographic observations, birth stories, and experiences as a patient to examine how birthing people, providers, and the Revolutionary state negotiate care and responsibility for health. I describe three fears: the fear of failure to protect maternal-infant health (and its repercussions for clinicians and the state); the fear of physiological childbirth; and fears of inadequate or violent care. Obstetric violence in Cuba is structural. As birthing people shift between primary and tertiary healthcare infrastructures with distinct epistemologies of care, they exert ambiguous agency to domesticate the hostile space of the hospital, building relations of reciprocity and performing docility and compliance. Finally, I look at the gratitude expected of patients and the consequences of refusing to recognize healthcare as a “gift.” This contemporary account of obstetric violence in Cuba contributes to calls by abolition feminists to study the obstetric institution in order to refuse and dismantle it, building life-affirming futures for maternity care worldwide.