Medicalisation and the Practice of Labour Augmentation in Mwanza, Tanzania

Abstract

Since the late 1900s, maternal health has increasingly been medicalised as a result of growing
global concerns about poor maternal outcomes. An example of this medicalisation process is
the use of oxytocin for labour augmentation. This practice of administering oxytocin to shorten
the duration of labour is increasingly questioned. Feminist scholars have often questioned the
routine use of oxytocin, depicting it as unnecessary and as an inappropriate use of the drug
that undermines women’s autonomy and contributes to negative birth experiences. However,
these feminist arguments overlook individual agency and the complex ways in which actors
encounter and interact with oxytocin as a part of medicalised maternal care. Using the
intersubjectivity framework, the study examines how oxytocin use is negotiated by women and
healthcare providers in Tanzania. This study is based on eight months of ethnographic
fieldwork that involved participant observation, a series of semi-structured in-depth interviews
with women, and informal conversations with women and health providers who had experience
with oxytocin during childbirth. The study shows that the use of oxytocin for labour
augmentation is coproduced through intersubjective negotiations between women and health
providers. Although it partially contradicts official guidelines, both groups view it as
beneficial, thereby normalising its use and weakening the existing debate that portrays women
primarily as subjects of medicalised care