Delivering the Nation, Raising the State: Gender, Childbirth and the

Abstract

In Bolivia, indigenous women's desires to give birth in an atmosphere of respect and cultural autonomy, as well as physicians' and politicians' attempts to mold the nation along racial lines, shaped the development of obstetric medicine. Based on oral histories of midwives, nurses and obstetricians, this study uses midwifery as a lens to examine the connections between nation-state formation and the development of obstetric medicine in Bolivia between 1900 and 1982. Putting midwives at the center of a study about nation-state formation reveals complexities that many male-centered studies miss: indigenous, mixed-race, and white Bolivian women played central roles in state projects and, through their embodiment of different forms of womanhood, influenced debates about Bolivian national identity. This study also engages groundbreaking feminist studies of the 1970s and '80s which showed that U.S. and European male physicians created obstetric medicine by pushing female midwives out of the practice. These physicians typically accused midwives of ineptitude and defined childbirth assistance as a scientific medical procedure that should not be practiced by women. While that pattern holds true in Bolivia to some extent, it does not explain the power dynamics that shaped childbirth assistance in Bolivia. Over the course of the twentieth century, Bolivian physician's desires to modernize childbirth assistance and childrearing practices intertwined with the efforts of Bolivia's elite to overcome what they considered the country's "Indian Problem."