| dc.description.abstract | Background: For pregnant and birthing women, maintaining a relationship
with the same health care practitioner is critical to establishing a sense of safety.
In postsocialist Serbia, where care is fragmented and depersonalized, this continuity is often missing. Patients are frequently handed over to new practitioners,
sometimes without even knowing the name of the person overseeing their care.
In response, many women turn to the private sector to keep the same practitioner
across their prenatal period and their birth by establishing a personal “connection” within the hospital that they believe will shield them from mistreatment
during childbirth.
Methods: Data presented in this paper were collected through participant observation in one public maternity hospital and one public primary care center in
Serbia; semistructured interviews with 14 physicians; and semistructured interviews with 80 women who had given birth in one public maternity hospital in
Serbia.
Results: Public maternity hospital physicians who supplement their income
working in the private sector have the power to blur the distinctions between
favors and services. They offer continuity of personalized care to their private
clients/patients once they enter the public system, and they themselves obtain
social and economic security unavailable to those working in only one sector.
At the same time, there is evidence that personalized continuity of care does not
actually shield women from mistreatment in hospitals.
Conclusions: The private sector is reshaping existing informal strategies and
blurring the lines between formal and informal payments. In the postsocialist
context, consumer practices are not separate from, but entangled with, informality. Neoliberalism has not brought about empowerment and eliminated informality, but has instead further exacerbated existing inequalities in maternity care in
Eastern Europe. | sr |
