Zwier, Robin Kanak
(2021)
Making Maternal Mortality Public: Racialized Reproduction in Medical Review, Investigative Journalism, and Birth Justice Activism.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
As public efforts to prevent maternal death in the U.S. intensify, racial disparities have become particularly salient—Black women and birthing people are 2-3 times more likely to die from pregnancy and childbirth complications than their White counterparts. Examining interrelated processes by which maternal mortality and racial disparities become public, this dissertation asks: How is maternal mortality made legible as an issue for public action? Rhetorical criticism of communication by public health and medical professionals, journalists, activists, and government officials, reveals how each approach illuminates some aspects of the problem while obscuring others. One case study explores how Maternal Mortality Review Committee (MMRC) data collection and assessment practices attune us to view pregnancy-related death as a physiological or medicalized phenomenon, in the process downplaying social determinants of health that may account for racial disparities. The ostensibly neutral evidentiary practice of excluding homicides and suicides from review may underestimate racial disparities in maternal mortality. The case of National Public Radio/ProPublica's "Lost Mothers Project" shows how media coverage can raise consciousness and make maternal mortality more actionable, even as it centers the norm of White motherhood by invoking entrenched figures of unhealthy/irresponsible Black bodies. A third case study focuses on how birth justice activists associated with the Black Mamas Matter Alliance strive to create a counterpublic that thematizes an alternative human rights framework for addressing the challenge. Rhetorical critique illuminates the relationship between frames used for making maternal mortality publicly legible and the solutions proposed for preventing maternal death, yielding original insight with implications for scholarship in public health, rhetoric of health and medicine, and reproductive justice. This study finds that because race-neutral approaches obscure how the U.S. legacy of violence and oppression toward Black birthing people configure the Black maternal body as risky, they are less likely to benefit Black birthing people and thus ameliorate alarming racial disparities. In addition, Given that prevailing medical standards and notions of evidence are insufficient to account for the work of reproductive justice organizations, the study highlights an urgent need to integrate knowledge and experience from these groups into standards for birth equity.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
8 October 2021 |
| Date Type: |
Publication |
| Defense Date: |
24 June 2021 |
| Approval Date: |
8 October 2021 |
| Submission Date: |
30 July 2021 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
280 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
Dietrich School of Arts and Sciences > Communication: Rhetoric and Communication |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
maternal mortality, racial disparities, reproductive justice, birth justice, publics, counterpublics, public health, rhetorical criticism, rhetoric of health and medicine, social determinants of health |
| Date Deposited: |
08 Oct 2021 19:21 |
| Last Modified: |
08 Oct 2021 19:21 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/41535 |
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