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Abstract
A close look at stories of maternal death in Malawi that considers their implications in the broader arena of medical knowledge. By the early twenty-first century, about one woman in twelve could expect to die of a pregnancy or childbirth complication in Malawi. Specific deaths became object lessons. Explanatory stories circulated through hospitals and villages, proliferating among a range of practitioners: nurse-midwives, traditional birth attendants, doctors, epidemiologists, herbalists. Was biology to blame? Economic underdevelopment? Immoral behavior? Tradition? Were the dead themselves at fault? In Partial Stories, Claire L. Wendland considers these explanations for maternal death, showing how they reflect competing visions of the past and shared concerns about social change. Drawing on extended fieldwork, Wendland reveals how efforts to legitimate a single story as the authoritative version can render care more dangerous than it might otherwise be. Historical, biological, technological, ethical, statistical, and political perspectives on death usually circulate in different expert communities and different bodies of literature. Here, Wendland considers them together, illuminating dilemmas of maternity care in contexts of acute change, chronic scarcity, and endemic inequity within Malawi and beyond
Intro -- Contents -- Introduction -- Bonnex Kaunda: "There are too many goings-on these days." -- 1. Dangerous Modernities -- Agnesi Kunjirima: "You can make your pregnancy safe." -- 2. Knowing Bodies -- Lillian Siska: "I help them right here at home." -- 3. Ambivalent Technologies -- Chimwemwe Bruce: "Changes, yes, but no development." -- 4. Abundant Scarcity -- Rhoda Nantongwe: "By the time she comes to the hospital, it is too late." -- 5. Countless Accountings -- Dyna Ng'ong'ola and Kettie Pensulo: "Women in this community are very much concerned." -- 6. Fragile Authority -- Conclusion -- Glossary of Chichewa Terms -- Key People and Places -- Abbreviations -- Acknowledgments -- Notes -- References -- Index.
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"Partial Stories takes readers to Malawi, where roughly one in twenty women can expect to die of a pregnancy or childbirth complication, despite decades of safe-motherhood programs. The stories of these mothers are told in hospitals and villages, by chiefs and doctors, herbalists and nurses, epidemiologists and healers, and competing explanations proliferate. The mothers' stories are used by elders for technical education and moral instruction at a coming-of-age-ritual, a district hospital's mortality review, and in the reflected glow of a computer screen at an international conference. After orienting readers to urban Malawi's context of therapeutic pluralism and material scarcity, Claire Wendland discusses the ways various experts account for maternal death, showing how their diverse explanations reflect competing visions of the past and shared concerns about social change. She looks to a series of pregnancy-related deaths in order to consider bodies as biosocial phenomena, shaped from before birth by history and social inequality. Wendland reveals an uneven therapeutic landscape that pushes experts to improvise, clinically and ethically. Their creative, essential, and sometimes deadly improvisations ask us to reconsider the "best practice" dogmas of global health and transnational research, as well as the nature of medical authority and expertise. Wendland demonstrates how strategies of legitimation render care more dangerous and knowledge more partial than it might otherwise be"--
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