This thesis investigated online communication of women utilizing a homebirth forum in order to understand why Canadian women are choosing homebirth methods instead of the mainstream dominant trend of hospital births, and how a sense of community is created through an online forum. For this research fifty posts were selected from fifteen different threads within the homebirth forum group on BabyCenter. The homebirth forum group was followed for approximately one month, and a total of thirty-four women are represented in the posting sample analyzed. Using content analysis techniques, four recurring themes were extracted – Control, Home, Hospitals, and Community – with at least four sub-themes for each identified. It was found that women choose homebirth for a myriad of factors but predominantly because homebirth allows for the ability to have a better sense of control, choice, and comfort over their birthing desires. As well, a sense of community is created in an online capacity because of the commonality of interests between the forum users. The solidarity of the homebirth community is built upon advice, empathy and situational understanding.

The purposes of this study were to explore the work of midwives and their experiences with the medical community, and to examine their goals and hopes for the profession of midwifery in Virginia. To facilitate this purpose, the guiding research questions included: What do midwives believe the role of a midwife is? What are their experiences with the medical community? What are their hopes and goals for the future of midwifery in Virginia? Through interviews, focus groups and participating as a researcher-observer, I found that both certified nurse-midwives and certified professional midwives believe the role of midwife is one of support. Furthermore, midwives' experiences with the medical community are both restrictive and supportive, and both groups are pursuing the advancement of midwifery acceptance and practice through building relationships and advocating for midwifery. The dominance of medical authoritative knowledge of childbirth in the United States creates struggles for midwives. Consequently networking and consumer advocacy are cited as vehicles for the growth of midwifery. / Master of Science

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This diploma thesis deals with home births and how they were referred to in the media regarding the medial cause with a midwife Ivana Königsmarková. The goal of this work is to describe approaches that can be traced on this cause, what is the gender dimension of these approaches like and how does the aspect of power manifest itself on them. To achieve that I've chosen a method of discourse analysis which is the best one to point out the relation between language, power and ideology. Analysed material is represented by the articles from Czech media that are associated with the given cause and on basis of which the most frequently occurring topics can be traced along with their tendencies throughout time. Last but not least I'm closely analysing two chosen articles which represent two dominant ways of thinking - the medical approach of labour and natural or alternative approach.

The topic of this thesis is woman's experience with natural childbirth and its potential for disruption of medical discourse, which is in the Czech Republic in obstetrics still dominating. Through the method of discoursive analysis I am trying to generate any behavior that may be in conflict with social expectations and may question norms and standards in the field of pregnancy and obstetrics. I am also trying to trace whether and how does the deepening and gaining of the birth knowledge lead to the transformation of woman's identity. Theoretically, the work is grounded in a post-structuralist paradigm and builds on the concepts of biopower, performative acting and authoritative knowledge. Data sources are stories written in support of a midwife Ivana Königsmarková and published on the internet (www.pribehyproivanu.cz).

This thesis is about primary care medicine in the United States today. Specifically, I look into primary care providers’ experiences working with patients in the context of the public’s current access to extensive health and medical information online. In this thesis, I discuss and analyze my conversations with physicians, nurse practitioners, and a physicians’ assistant about their objectives in primary care, the challenges they face, and their perceptions of patients’ ability to seek out information on their own. I explore providers’ educational emphasis in primary care consultations, and argue that this focus on education informs their views of patients’ independent research and involvement in care. I further argue that regardless of my informants’ enthusiasm about patient involvement and the merits of patient-education, these providers still hold and express a strong authority over medical knowledge and decisions. Thus in looking at the influence of what could be seen as a democratization of medical knowledge through public access and the Internet, it seems that the limitations of such access are still great in U.S. medical practice.

Pregnancy and childbirth complications are a leading cause of death and disability among women of reproductive age in developing countries. Worldwide data shows that, by choice or out of necessity, 60 percent of births in the developing world occur outside a health institution and 47 percent are assisted by Traditional Birth Attendants (TBAs), family members, or without any assistance at all. This thesis argues that TBAs in India have the capacity to disseminate knowledge of beneficial maternal practices to the community. Since the 1970s the training of TBAs has been one of the primary single interventions encouraged by World Health Organisation (WHO) to address maternal mortality. However, since the 1990s international funding for TBAs has been reduced and the emphasis has shifted to providing skilled birth attendants for all births due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Researchers have observed that the shift in policy has taken place without adequate evidence of training (in)effectiveness and without an alternative policy in place. This thesis argues further that two main types of birthing knowledge co-exist in India; western biomedicine and traditional knowledge. Feminist, anthropological, and midwifery theorists contend that when two knowledge paradigms exist, western knowledge tends to dominate and claim authority over local ways of knowing. The thesis used such theories, and quantitative and qualitative methods, to assess whether the local TBA training programmes in Ahmednagar District in India have been successful in disseminating biomedical knowledge in relation to the birthing practices of local TBAs and in incorporating local knowledge into the training. The data revealed that some biomedical knowledge had been successfully disseminated and that some traditional practices continue to be practiced in the community. There is a top-down, one-sided imposition of biomedical knowledge on TBAs in the training programme but, at the local level, TBAs and mothers sometimes follow the training instructions and sometime do not, preferring to adapt to the local perceptions and preferences of their community. The thesis reveals the significance of TBA training in the district but queries the effectiveness of not including local TBA practices into the training programmes, arguing this demonstrates the hierarchical authority of biomedicine over local traditional practices. The thesis highlights the significance of community awareness that accompanies TBA training and makes recommendations in order to enhance training outcomes.

L’adoption grandissante des caméras portatives par les organisations policières dans les dernières années a visé plusieurs objectifs. Il est généralement attendu que l’utilisation de la technologie puisse contribuer à rendre les organisations plus transparentes, à assurer une plus grande imputabilité des policiers, ou encore à réduire l’utilisation de la force à l’endroit des citoyens. En étant activées lors des interventions policières, les caméras portatives permettraient aussi la production d’enregistrements qui pourront être utilisés tout au long de la chaîne judiciaire, que ce soit lors d’enquêtes ou de procédures judiciaires. Toutefois, la littérature scientifique s’étant largement intéressée aux impacts des caméras portatives sur les interactions entre les policiers et les citoyens, les conséquences de leur utilisation sur les tribunaux demeurent un aspect toujours sous-étudié. La présente thèse vise à mieux comprendre l’apport des enregistrements de caméras portatives au traitement des causes criminelles par les tribunaux. Quatre objectifs spécifiques sont visés : 1) explorer les représentations que se font les acteurs judiciaires de la valeur probante des images de caméras portatives ; 2) mieux comprendre le rôle des images de caméras portatives dans les pratiques des acteurs judiciaires ; 3) mettre en lumière les éléments pouvant affecter le recours aux images de caméras portatives ; et 4) évaluer l’impact de la disponibilité des images de caméras portatives sur le traitement des causes criminelles par les tribunaux, et plus particulièrement sur les verdicts de culpabilité et le temps de traitement des dossiers. Le point de départ de la thèse est un projet pilote de caméras portatives mené par le Service de police de la Ville de Montréal, et une méthodologie mixte conjuguant des entretiens menés auprès de procureurs et d’avocats de la défense (N = 22) à l’analyse statistique de données issues de dossiers judiciaires (N = 525) permet de répondre aux objectifs énoncés. D’un point de vue empirique, il est soutenu que l’apport des images de caméras portatives au processus judiciaire représente une forme de paradoxe, où la forte valeur probante étant associée aux images par les acteurs judiciaires ne correspond pas totalement à l’utilisation qui en est faite ni aux impacts qui sont observés sur le traitement des dossiers. Bien qu’une baisse significative du temps de traitement soit observée pour certains dossiers, plusieurs facteurs semblent mettre un frein à l’utilisation des images par les acteurs judiciaires. D’un point de vue théorique, la thèse propose d’approfondir les réflexions sur le pouvoir de l’image dans le processus judiciaire. En empruntant la notion de savoir autoritaire, il est soutenu que le paradoxe observé dans l’apport de l’image au processus judiciaire puisse s’expliquer par la source même de la supériorité de la preuve. Au-delà de leur contribution potentielle à la découverte des faits, les images de caméras portatives sont utilisées dans un contexte où la productivité du tribunal demeure un objectif central, ce qui peut amener les acteurs judiciaires à accorder une priorité à d’autres formes d’information, dont la version des policiers. / The growing adoption of body-worn cameras by police organizations in recent years has served several objectives. It is generally expected that the use of this technology will help make organizations more transparent, ensure greater accountability for police officers, or even reduce the use of force against citizens. By being activated during police interventions, body-worn cameras would also allow the production of recordings that can be used throughout the judicial chain, whether during investigations or legal proceedings. However, scientific literature having been mainly interested in the impacts of body-worn cameras on interactions between police officers and citizens, the consequences of their use on courts remain an aspect that is still understudied. This thesis aims to better understand the contribution of body-worn camera recordings to the processing of criminal cases by courts. Four specific objectives are targeted: 1) to explore the representations that judicial actors have of the evidentiary value of body-worn camera recordings; 2) to better understand the role of body-worn camera recordings in the practices of judicial actors; 3) to highlight the elements that may affect the use of body-worn camera recordings; and 4) to assess the impacts of the availability of body-worn camera recordings on the processing of criminal cases by courts, and more particularly on guilty verdicts and case processing times. The starting point of the thesis is a body-worn camera pilot project led by the Service de police de la Ville de Montréal, and a mixed methods design combining interviews conducted with prosecutors and defence lawyers (N = 22) with statistical analysis of data from court cases (N = 525) is used to meet the stated objectives. From an empirical standpoint, it is argued that the contribution of body- worn camera recordings to the judicial process represents a form of paradox, where the high evidentiary value being associated with images by the judicial actors does not fully correspond to the use that is made of it or the impacts that are observed on case processing. Although a significant reduction in processing time is observed for some cases, several factors seem to put a brake on the use of recordings by judicial actors. From a theoretical standpoint, the thesis proposes to deepen the reflections on the power of images in the judicial process. By borrowing the notion of authoritative knowledge, it is argued that the paradox observed in the contribution of body-worn camera recordings to the judicial process could be explained by the very source of their superiority. Beyond their potential contribution to the discovery of the facts, body-worn camera recordings are used in a context where productivity remains a central objective to the court, which can lead judicial actors to prioritize other forms of information, including police officers’ versions.

Esta tese propõe uma contribuição para as análises do campo obstétrico pré-natal sendo o seu objeto a transmissão e circulação do "saber autorizador" a partir das experiências de mediação tecnológica com a cardiotocografia num contexto institucional local. O principal objetivo é mostrar que o campo obstétrico contemporâneo se constrói a partir da afirmação do feto/bebê como seu símbolo dominante. Para tanto direcionei o meu olhar para a dinâmica dos agentes institucionais em torno da tecnologia da cardiotocografia, observando as relações entre o conceito de "saber autorizador" e o simbolismo dominante contextual. Embora o conceito de "saber autorizador" tenha sido originalmente proposto para a compreensão da dinâmica dos agentes do campo obstétrico, ele foi atribuído apenas aos profissionais médicos que dominam as tecnologias de controle da condição fetal, portanto, supondo que a autoridade deste saber se encontra circunscrito a este grupo de agentes. No entanto, quando se apresenta a perspectiva da incorporação deste saber pelos múltiplos agentes do campo incluindo as gestantes, encontramos o direcionamento conjunto para uma categoria central híbrida que confere autoridade tanto ao saber quanto à experiência do grupo articulado à tecnologia obstétrica. A metodologia consistiu na observação participante da dinâmica da cardiotocografia numa Maternidade Pública do município do Rio de Janeiro, incluindo entrevistas semi-estruturadas com cinco médicos, agentes a quem o saber autorizador é originalmente atribuído. As representações dos entrevistados disponibilizaram quatro categorias: a história, os valores, os instrumentos tecnológicos e as emoções que são incorporadas/corporificadas em torno da relação do saber e da experiência de cuidado com o feto/bebê. Estas categorias serviram para a análise da observação do campo, resultando na construção da nova categoria - a vitalidade fetal - que verifica o simbolismo dominante conferido pelo feto/bebê e que mostra de maneira aprofundada o movimento contemporâneo do campo obstétrico em direção à perinatologia. / This theses aims to contribute to the analysis of the prenatal obstetrical field concerning its object which is the transmission and circulation of the authoritative knowledge from technological mediated experiences with cardiotocography in a local institutional context. The main purpose is to show how the obstetrical field is built within the affirmation of the fetus/baby as its dominant symbol. To reach this consent I turned my gaze to the dynamics of cardiotocography and its relationship between the authoritative knowledge and the contextual symbolism. Although the authoritative knowledge was a concept originally intended to explain the dynamics of the obstetrical field in regard to technology, it was only attributed to medical professionals who were able to deal with the obstetrical technology, disregarding the multiple agents who embody knowledge and experience which eventually enact a central hybrid category attached to the obstetrical technology. The methodology was based on the participant observation of a public maternity in the city of Rio de Janeiro, where I also interviewed five medical professionals to whom the authoritative knowledge is attributed. Their representations disposed four categories: their history, values, technological instruments and emotions, which are all, embodied around the relationship of knowledge and experience with the fetus/baby care. These categories were used in the fieldwork analysis to verify the dominant symbolism concerning the fetus/baby and also to demonstrate the construction of a new category the fetal vitality that explains the movement of the obstetrical field towards perinatology.

Esta tese propõe uma contribuição para as análises do campo obstétrico pré-natal sendo o seu objeto a transmissão e circulação do "saber autorizador" a partir das experiências de mediação tecnológica com a cardiotocografia num contexto institucional local. O principal objetivo é mostrar que o campo obstétrico contemporâneo se constrói a partir da afirmação do feto/bebê como seu símbolo dominante. Para tanto direcionei o meu olhar para a dinâmica dos agentes institucionais em torno da tecnologia da cardiotocografia, observando as relações entre o conceito de "saber autorizador" e o simbolismo dominante contextual. Embora o conceito de "saber autorizador" tenha sido originalmente proposto para a compreensão da dinâmica dos agentes do campo obstétrico, ele foi atribuído apenas aos profissionais médicos que dominam as tecnologias de controle da condição fetal, portanto, supondo que a autoridade deste saber se encontra circunscrito a este grupo de agentes. No entanto, quando se apresenta a perspectiva da incorporação deste saber pelos múltiplos agentes do campo incluindo as gestantes, encontramos o direcionamento conjunto para uma categoria central híbrida que confere autoridade tanto ao saber quanto à experiência do grupo articulado à tecnologia obstétrica. A metodologia consistiu na observação participante da dinâmica da cardiotocografia numa Maternidade Pública do município do Rio de Janeiro, incluindo entrevistas semi-estruturadas com cinco médicos, agentes a quem o saber autorizador é originalmente atribuído. As representações dos entrevistados disponibilizaram quatro categorias: a história, os valores, os instrumentos tecnológicos e as emoções que são incorporadas/corporificadas em torno da relação do saber e da experiência de cuidado com o feto/bebê. Estas categorias serviram para a análise da observação do campo, resultando na construção da nova categoria - a vitalidade fetal - que verifica o simbolismo dominante conferido pelo feto/bebê e que mostra de maneira aprofundada o movimento contemporâneo do campo obstétrico em direção à perinatologia. / This theses aims to contribute to the analysis of the prenatal obstetrical field concerning its object which is the transmission and circulation of the authoritative knowledge from technological mediated experiences with cardiotocography in a local institutional context. The main purpose is to show how the obstetrical field is built within the affirmation of the fetus/baby as its dominant symbol. To reach this consent I turned my gaze to the dynamics of cardiotocography and its relationship between the authoritative knowledge and the contextual symbolism. Although the authoritative knowledge was a concept originally intended to explain the dynamics of the obstetrical field in regard to technology, it was only attributed to medical professionals who were able to deal with the obstetrical technology, disregarding the multiple agents who embody knowledge and experience which eventually enact a central hybrid category attached to the obstetrical technology. The methodology was based on the participant observation of a public maternity in the city of Rio de Janeiro, where I also interviewed five medical professionals to whom the authoritative knowledge is attributed. Their representations disposed four categories: their history, values, technological instruments and emotions, which are all, embodied around the relationship of knowledge and experience with the fetus/baby care. These categories were used in the fieldwork analysis to verify the dominant symbolism concerning the fetus/baby and also to demonstrate the construction of a new category the fetal vitality that explains the movement of the obstetrical field towards perinatology.