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    Childbearing in Timor-Leste : beliefs, practices and issues : a thesis presented in fulfilment of the requirements for the degree of Master of Philosophy in Development Studies, Massey University
    (Massey University, 2005) Thomas, Bronwyn
    Timor-Leste is country with a past, a past that reveals considerable strength and a will to achieve the right to be self determining. It is also a country that will need development assistance for many years to come. Lack of development by Portugal, the former colonial power, compounded by an illegal and destructive occupation by Indonesia it was a country largely devoid of infrastructure at the time of independence in 2002. The population of this small half island is diverse, ethnically and linguistically. The population is considered to be amongst the poorest in the world and women's health, particularly the high maternal mortality rates and the issue of domestic violence have been identified as key areas for development. Women's marginal status in Timorese society is due to traditional and patriarchal practices which enable males to exert control and power over women in many facets of daily life. One of the numerous results of this is that women have reduced access to valued resources including health, education and food. Children are greatly valued, but the high fertility and maternal mortality rates has led the government to identify reproductive health as a high priority. Childbirth is only one aspect of reproductive health but it has traditionally received greater attention. Utilising qualitative research a small group of rural women shared their experiences and practices of childbearing. One aspect the women identified was a lack of information as childbirth is a taboo subject until a woman becomes a mother. In view of this and the numerous priorities identified by Timorese government for future work, including the mainstreaming of gender health concerns I consider the research findings. Due to the need for cost effective and sustainable programmes I recommend Adolescent Sexual Reproductive Health (ASRH) as an area for future exploration and consideration. This is an area found to be commonly overlooked in development activities, but can have many positive outcomes. A broad ASRH programme could address not only the issues of poor information but also work toward challenging gender norms and values which are key influences on women's reproductive health and childbearing experiences. ASRH may be controversial, but some consider programmes can be implemented as early as ten years of age. As adolescents are the next generation of parents and the most receptive to change they are the ideal target group for the future health of this country.
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    Caesarean section in the absence of clinical indications : discourses constituting choice in childbirth : thesis submitted to Massey University of Palmerston North in fulfilment of the requirements for the degree of Doctor of Philosophy in Midwifery, Massey University, Palmerston North
    (Massey University, 2007) Douche, Jeanie Raeburn
    This poststructuralist qualitative study explored the discourses constructing women’s choice for a caesarean section in the absence of clinical indications, in the talk and texts of women, midwives, an obstetrician, professional journals and the media publications. The study affirms inscriptions surrounding choice in childbirth are shaped discursively through a multiplicity of discourses underpinned by social and institutional practices. With advances in technology, childbearing women have a greater variety of options from which to choose. Controversial, is the option of a caesarean section, regardless of clinical need. The issue is depicted in both professional and popular discourse as contentious, complex and contradictory. Its momentum into the 21st century, as a new object of obstetric discourse, has been played out on a number of platforms. In this thesis I draw from the theoretical ideas of French philosopher Michel Foucault, to examine this complex debate. I argue there is a volatile moment in the history of childbirth in which an explosion of discourses have sculptured choice for a caesarean, in the absence of clinical indications, out of a repartee of autonomy, convenience, desire, fear and risk. In this precarious moment, new meanings joust with the old on a shifting terrain awash with rhetoric that co-opts, competes, and contradicts to bring about a caché of mutable ‘truths’. Whether caesarean, as an optional extra, can be explained in terms of a libertarian imperative, an embodiment of lifestyle, the satiation of desire, the attenuation of fear or the avoidance of risk, the democratisation of this choice has exposed a pathologising paradox, whereupon the normal emerges as the abnormal, and the abnormal emerges as the normal. The deconstruction of choice through a poststructuralist lens has enabled insight into how contradiction and contest befall the ‘order of things ’ and in so doing, provides new openings for contemplating the discursive positioning of women through the competing discourses of childbirth.