Emotional labour: Exploring emotional policy discourses of pregnancy and childbirth in Ontario, Canada

Publication Date01 Apr 2021
AuthorStephanie Paterson
DOI10.1177/0952076719869786
SubjectRegular Articles
untitled Article
Public Policy and Administration
2021, Vol. 36(2) 252–272
Emotional labour:
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Exploring emotional
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DOI: 10.1177/0952076719869786
policy discourses of
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pregnancy and childbirth
in Ontario, Canada
Stephanie Paterson
Department of Political Science, Concordia University, Montreal,
Canada
Abstract
In 1991, Ontario became the first Canadian province to pass legislation establishing
midwifery as a self-regulated healthcare profession and integrating it into the pro-
vincial healthcare insurance plan. Since its implementation, there has been a partial
convergence of obstetric practice in the province, where, despite seemingly distinct
professional philosophies of care, both midwives and physicians cohere around rep-
resentations of pregnancy and birth as ‘‘normal’’ or ‘‘natural’’ life events rather than
medical conditions requiring treatment. In this paper, I suggest that understanding
this convergence and the effects produced by it requires an interrogation of the
emotional policy discourses that shape (and are shaped by) the ways we experience
the world around us. In doing so, I develop a framework for tracing the emotional
policy discourses surrounding pregnancy and birth from the turn of the 20th century
until the early 1990s, demonstrating that these representations reflect the merging
of two emotional registers, joy and fear, where pregnancy and birth are represented
as joyous, life changing events, but where joy is tempered by the fear of complica-
tions and potential tragedy. I thus show that contemporary emotional landscapes
bind various ‘‘birth experts’’ and bracket ‘‘expertise’’ around particular forms of
knowledge, shaping expert and maternal subjectivities along gendered, racialized,
ableist, and class-based lines.
Keywords
Canada, emotional discourse, feminist policy analysis, reproductive politics
Corresponding author:
Stephanie Paterson, Concordia University, 1455 de Maisonneuve Blvd. W. Montreal, Quebec H3G 1M8,
Canada.
Email: stephanie.paterson@concordia.ca

Paterson
253
Until the early 1990s, Canada was the only Western country that did not recognize
midwifery as part of its obstetric care system.1 In 1991, however, Ontario became
the f‌irst province to pass legislation establishing midwifery as a self-regulated
profession and integrating it into the provincial healthcare insurance plan, of‌fering
full funding for midwife attended births in homes, hospitals or birth centres.
The legislation marked the end of nearly a decade of contentious public debate
about midwifery, during which physicians, who had previously enjoyed a mono-
poly over obstetric care in the province, shifted from a position of vehement
rejection to tentative acceptance.
Since the implementation of midwifery, there has been a partial convergence of
obstetric practice in the province. On the one hand, midwifery has been criticized
for increasingly resembling the biomedicine it initially critiqued, reproducing a
hierarchy of knowledge and expertise that privileges biomedical science.2 Indeed,
some have argued that a new form of birth expert – the professional midwife – has
emerged, acting ‘on’, rather than ‘with’, maternal subjects (Paterson, 2010). On the
other hand, biomedical approaches to birth have also changed, tending toward
fewer interventions and encouraging involvement from birthing subjects and
their families. To be sure, despite seemingly distinct professional philosophies of
care, both midwives and physicians cohere around representations of pregnancy
and birth as ‘‘normal’’ or ‘‘natural’’ life events rather than medical conditions
requiring treatment.
In this paper, I suggest that understanding this convergence and the ef‌fects
produced by it requires an interrogation of the emotional discourses that shape
(and are shaped by) the ways we experience the world around us. To do so, I trace
the emotional policy discourses surrounding pregnancy and birth from the turn of
the 20th century until the early 1990s, demonstrating how emotional landscapes
lend coherence to seemingly disparate professional discourses and practices, bind-
ing ‘‘experts’’ and bracketing ‘‘expertise’’ around particular forms of knowledge.
I illuminate three distinct periods that are dif‌ferentially shaped by two emotional
discourses, joy and fear. Until the mid-20th century, representations of pregnancy
and birth were constituted by a discourse of fear, where fear of pain and poor
outcomes coproduced birth practices centering on biomedical expertise. From the
mid-20th century until the 1980s, a discourse of joy constituted representations of
pregnancy and birth, coproducing birth practices emphasizing happiness and, in
many cases, empowerment in and through the birth process. In the third period,
from the 1980s to the present day, representations of pregnancy and birth ref‌lect
the merging of these two emotional discourses, where pregnancy and birth are
represented as joyous, life changing events, but where joy is tempered by fear of
complications and potential tragedy. I demonstrate that the merging of joy and fear
produces a discourse of risk, upon which biomedical science and midwifery con-
verge (e.g. Coxon et al., 2014; Fannin, 2013; Possamai-Inesedy, 2006). I argue that
the risk discourse coproduces birth practices that privilege scientif‌ic expertise,
thereby constituting expert and maternal subjectivities along gendered, racialized,
ableist, and class-based lines.

254
Public Policy and Administration 36(2)
To make these claims, I draw on feminist policy analysis and cultural theories of
emotion to develop a framework for investigating how emotional policy discourses
are implicated in social processes that situate subjects in complex structures of
penalty and privilege. Indeed, policy studies is in the midst of an ‘‘emotional
turn’’, of‌fering a necessary corrective to the neutral bureaucrat archetype that
dominates the f‌ield. Yet how emotional policy discourses shape and are shaped
by power relations remains unclear, despite a vast literature detailing how emotions
are gendered and racialized. The case of pregnancy and birth in Ontario, Canada,
provides the opportunity to examine how maternal bodies are marked, surveilled
and regulated within emotional discursive f‌ields, illuminating how emotional dis-
courses shape what can be said, thought, and felt, and how these limits produce
various subjectif‌ication and material ef‌fects. In what follows, I begin by outlining
an approach for conducting emotional policy discourse analysis, followed by an
application to pregnancy and birth politics in Ontario. I conclude with some ref‌lec-
tions on the potential of emotional policy discourse analysis to provide insight into
how policies are lived and how we might reimagine them in more socially just ways.
Discourse and emotions: Towards a feminist framework for
emotional policy analysis
There is a growing literature on public policy and emotions. Building on broader
multidisciplinary scholarship on emotions,3 this work has identif‌ied the emotional
dimensions of activism (Anderson, 2014; Orsini and Wiebe, 2014) and networks
(Ingram et al., 2015); policy rhetoric (Gottweis, 2012), framing (Gross, 2008) and
debate and deliberation (Martin, 2012; Welch, 1998); public administration
(Anderson, 2002, 2017; Husso and Hirvonen, 2012); and governance (Durnova,
2013; Durnova and Hejzlarova´, 2018; Newman, 2017). In addition, a number of
works seek to examine emotions in particular policy f‌ields, such as international
relations and foreign policy (Mercer, 2010), social assistance (Hancock, 2004; Small
and Lerner, 2008), and social and employment policy (Cook, 2012; White, 2017).
Moreover, some have explored how we might ‘do’ emotional policy analysis,
identifying some of the potential epistemological concerns that arise from doing
so (Newman, 2012).
A dominant strain of this literature demonstrates how emotional discourses
mobilize, politicize, and position particular actors. In contrast to instrumentalist
approaches, where understanding emotions is promoted as essential to political
leadership (Richards, 2007; Westen, 2008) or ‘‘nudges’’ (Thaler and Sunstein,
2008), for example, discursive approaches of‌fer what Newman (2012: 466) suggests
are a more ‘‘f‌ine grained analysis of how emotional regimes of governance are
enacted [. . .].’’ In this sense, emotions, expectations, and responses are not neces-
sarily separate from rational processes, or something that can be discretely under-
stood, managed and acted on in order to make ‘‘better’’ policies or decisions.
Instead, emotions are uncovered through discourse analysis,4 rather than assumed
or determined in advance. As discourse, def‌ined by Hajer (1993: 45) as, ‘‘an

Paterson
255
ensemble of ideas, concepts and categories through which meaning is given to
phenomena’’ that is produced in and reproduces a set of identif‌iable practices
(Hajer, 2011), emotions are constitutive of meanings shaping how we understand
and feel about the world around us, as well as self, other, and community (e.g.
Ahmed, 2004; Newman, 2012, 2017). While this work has enriched our under-
standing of the discursive dimensions of emotions in policy processes and out-
comes, it remains unclear how these concepts address an emotional-discursive
terrain that is marked by a complex system of penalty and privilege.
This insight is acknowledged within cultural theories of emotions. In these
works, emotions are socially mediated, productive forces...

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