Topçu Sezin
Centre National de la Recherche Scientifique and Centre d'Étude des Mouvements Sociaux (CNRS-EHESS-INSERM), Paris, France.
Reprod Biomed Soc Online. 2021 Apr 9;13:1-13. doi: 10.1016/j.rbms.2021.03.002. eCollection 2021 Aug.
With a national rate of 82.4%, France is currently one of the world's leading users of epidural analgesia (EA), which is promoted not just as a pain reliever but also as a technology that makes childbirth safer. Drawing on analytical tools from science and technology studies, reproductive studies and ignorance studies, I will show how this obstetric drug came to be widely used after significant knowledge/ignorance battles had been fought during heated public and medical controversy in the 1970s. Different visions of the 'knowns', the 'unknowns' and 'know-how' came into conflict in this context, supported by a series of moral, political and feminist justifications that were often at odds with one another. While the defenders of natural birth clashed with feminists, created ambiguities around conceptions of the maternal body, and struggled to produce large-scale clinical knowledge on the risks of EA, the defenders of EA put forward technological promises and biomedical modernization as a means to outstrip the knowledge wars. In the aftermath of this epistemic battle, EA was to gradually become an 'unlearner' technology; that is, a modern tool that radically silenced the maternal body and led to denial, disregard or unawareness of a whole range of shared and alternative knowledges and 'know-how' relating to female physiology and the birth process that are free of pharmaceutical products and medical interventions.
法国目前是世界上硬膜外镇痛(EA)的主要使用国之一,全国使用率达82.4%。硬膜外镇痛不仅被宣传为一种止痛方法,还被视为一种能让分娩更安全的技术。运用来自科学技术研究、生殖研究和无知研究的分析工具,我将展示这种产科药物在20世纪70年代激烈的公众和医学争论中经历了重大的知识/无知较量后,是如何开始广泛使用的。在这种背景下,关于“已知”“未知”和“技术诀窍”的不同观点发生了冲突,一系列道德、政治和女权主义的理由相互矛盾,为这些观点提供了支持。自然分娩的支持者与女权主义者发生冲突,在母体身体概念上制造了模糊性,并努力就硬膜外镇痛的风险产生大规模临床知识,而硬膜外镇痛的支持者则提出技术承诺和生物医学现代化,以此来超越知识之争。在这场认知之战的余波中,硬膜外镇痛逐渐成为一种“消除知识”的技术;也就是说,一种现代工具,它从根本上使母体身体沉默,并导致对一系列与女性生理和分娩过程相关的、不依赖药品和医疗干预的共享知识和“技术诀窍”的否认、忽视或无知。