Empowerment through Intimacy: The Case of Czech Homebirth Controversy

Current debates on health care policies are often rife with emotional content pointing to competing values, beliefs and interests and raising through this competition the question about who is the relevant expert to decide over a health care measure, what knowledge counts as the right one and how this knowledge should be communicated. Not only patients are those who are being seen as increasingly empowered in these debates, but the citizen empowerment draws the analogy between the change in the relationship between patients and doctors and the interactions between experts and lay persons stated repeatedly in the current research on the role of discourses in public policies.

This paper analyzes the case of the Czech controversy around homebirth in order to show the dynamic of the empowerment and the specific role of intimacy in it. Czech home birth policy debate has raised to a controversy presenting homebirth primarily as a threat to the child’s security, to maternal responsibility and revealing by that the conflict over professional territorialism between obstetrics, midwifery and mothers. In that way, the controversy problematizes the issue of citizen empowerment. By focusing on arguments for and against homebirth and by identifying the actors taking part in the debate the analysis suggests that the particular choice for a way of giving birth is being translated as a choice based on intimacy.

Intimacy refers here to the concern about the appropriateness of a particular emotional experience of birth and is transmitted through appeals to particular values and beliefs and interests related to the way of giving birth. In the analysis, the phrase “empowerment through intimacy” joins the recent public policy debate on citizen empowerment and the relationship between experts, patients and policy makers and traces how intimacy affects it.