April 4 Devon Golaszewski (Loyola Marymount, LA)

“Medicalizing Childbirth in Post-Colonial Mali: Uterine Stimulant Drugs as Techno-Medical Tools and Social Cures”

By the 1970s, uterine stimulant and oxytocic drugs such as Pitocin and Methylergometrine were widely used to manage childbirth in Mali. Rural maternity wards stocked these drugs to stop post-partum hemorrhage and to speed labor, and health personnel moonlighting after-hours pushed their use to augment contractions. Why did these drugs become so widespread? On the one hand, biomedical obstetric workers used these drugs as a tool to respond to risky birth in a context of patchy infrastructure. The distance between rural clinics and reference hospitals, and the challenges of traveling between them, meant that health workers sought to avoid having to refer women. Uterine stimulant drugs thus served as a techno-medical tool to paper over systemic infrastructural challenges. But the use of uterine stimulant drugs as a “magic bullet” to solve a systemic health issue, a classic narrative of post-colonial African health policy, is only part of the story.Malian women also actively sought to avoid prolonged labor. For Malians, one possible explanation for a difficult birth was the woman’s sexual misbehavior, and prolonged labor opened Malian women to accusations of adultery. To avoid this risk, Malian women sought to manage childbirth in a way which would avoid any suspicions (including through the use of plant medicines with oxytocic properties). Some women thus welcomed pharmaceutical uterine stimulant drugs to speed labor and avoid the social risk of problems in childbirth. This paper explores how and why certain medical technologies are taken up, and the multiple origins of the “pharmaceuticalization” of childbirth.

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