Bearing Culture: Resources, Networks and the Transition to New Motherhood By Sarah Bracey Garrett A dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Philosophy in Sociology in the Graduate Division of the University of California, Berkeley Committee in charge: Professor Ann Swidler, Chair Professor Arlie Hochschild Professor Robert Willer Professor Dacher Keltner Fall 2013 Abstract Bearing Culture: Resources, Networks and the Transition to New Motherhood by Sarah Bracey Garrett Doctor of Philosophy in Sociology University of California, Berkeley Professor Ann Swidler, Chair This dissertation is about women and their cultural resources as they progress through pregnancy, birth, and early parenthood. Specifically, it focuses on a key interpretive resource: the "cultural frames" (Goffman 1974) women encounter that are relevant to the settings, practices and outcomes they face during this important social moment (e.g., labor and delivery as a high- or low- risk environment, breast-feeding as compulsory or optional). Pregnant women's perspectives, and individual-level cultural resources more generally, are under-researched in the social sciences. Few scholars study how pregnant women in the U.S. perceive self-, birth- or infant-care practices during this key life stage. Those that do typically focus on narrow topics and/or narrow segments of the population. And, significantly, a great deal of research in this and other health-related subfields assumes that individuals’ views track with— and are sufficiently measured by—characteristics such as race/ethnicity, immigrant status, and nationality. At the same time, research on individual-level cultural resources has been stalled by the difficulty of operationalizing them. Cultural repertoire theory, for example, is conceptually useful and widely used (Swidler 1986, 2001; Lamont 1992), but it has been the subject of very little direct empirical study. For this dissertation I designed a survey instrument that could (a) capture multi- dimensional data on pregnant women’s perspectives, and (b) operationalize the cultural resources—here cultural frames—in individuals’ repertoires. The module appeared in a series of longitudinal surveys and interviews of a socio-economically- and racially-diverse group of pregnant women in Northern California. I use the survey data to answer the following three questions. Chapter 1: What is the cultural landscape of pregnancy for contemporary women, and in what regards does it vary by social location? Focusing primarily on the cultural frames that these women encounter about peri-natal practices and settings, I find (a) that more and less privileged women have divergent—but not radically different—landscapes, and (b) that exposure to contradictory frames is universal, though greater among highly-educated women. I also find a complex relationship between individuals’ exposure to and endorsement of specific cultural frames. Investigating these "cultural landscapes" contributes novel data to the study of pregnancy and birth in the contemporary U.S., and enriches the study of culture in health research. 1 For Chapters 2 and 3, I conceptualized familiarity with diverse frames about a topic as having multiple cultural "tools" in one's repertoire, and calculated a cultural repertoire diversity score (CRD) based on this. Repertoire theory posits that culture affects individuals by giving them tools, such as cultural frames and styles of self-presentation, with which they interpret, navigate, and act in and on social life (Swidler 1986). Chapter 2: What individual-level characteristics predict more or less diverse cultural repertoires? I use CRD score as a dependent variable to investigate whether more privileged respondents “consume” a wider variety of cultural frames than do less privileged individuals; and whether this consumption is related to respondents’ social network characteristics. I find that educational achievement and social network diversity independently predict repertoire diversity. These analyses reveal a new way in which human and social capital confer cultural resources. Chapter 3: Does having a more diverse cultural toolkit lead to greater individual well- being, as cultural repertoire theory would predict? Employing longitudinal data and CRD score as an independent variable, I find that women with more diverse cultural repertoires in fact experience worse postpartum socio-emotional outcomes than do their counterparts, net of relevant covariates. Drawing on social psychology, I posit that diverse cultural resources in this context may function less as tools individuals use to "solve" problems, and more as reference points against which to compare their experiences. This paper overcomes a long-standing barrier to understanding how culture impacts social life and identifies a previously unrecognized socio- cultural influence on postpartum mental health. By operationalizing and directly measuring individual-level cultural resources, and by doing so in a more diverse sample of women then is typically studied in research on women’s reproductive lives, this dissertation contributes new information to cultural sociology, to the study of culture in health contexts, and to research on contemporary pregnancy, birth and new motherhood. 2 For my parents, Pam and Dan Garrett, with great love and gratitude. i CONTENTS ACKNOWLEDGMENTS ......................................................................................................... iii INTRODUCTION ......................................................................................................................v CHAPTER 1 - The Cultural Landscape for Expectant Mothers: Contemporary Women’s Exposure to and Attitudes toward Select Health- and Infant-care Practices ..................................1 Tables for Chapter 1 .............................................................................................................. 26 CHAPTER 2 - Foundations of the Cultural Repertoire: An Investigation of Education and Social Network Effects among Expectant Mothers .................................................................... 41 Tables for Chapter 2 .............................................................................................................. 54 CHAPTER 3 - Too Many Tools? The Consequences of Cultural Repertoire Diversity among Expectant Mothers .................................................................................................................... 57 Tables for Chapter 3 .............................................................................................................. 75 CONCLUSION ......................................................................................................................... 81 BIBLIOGRAPHY ..................................................................................................................... 84 APPENDIX A ........................................................................................................................... 96 APPENDIX B ........................................................................................................................... 97 APPENDIX C ........................................................................................................................... 99 ii ACKNOWLEDGMENTS There are many people I wish to thank for having made this dissertation, and my completion of grad school, possible. First, I am grateful to the over 300 pregnant women in the California Bay Area who voluntarily agreed to participate in this research project. They gave generously of both time and energy at a time when they had little to spare. I hope to honor them by producing research that can improve maternal care and outcomes for women like them. This project owes a great deal to Professor Aaron Caughey, M.D./Ph.D., who in 2009 was a researcher-clinician at U.C. San Francisco. I had spent almost a year trying to gain research access to local prenatal care clinics, with no luck. After much networking, I managed to cross paths with Dr. Caughey, who invited me to collaborate with his warm and capable research team. It was only through this collaboration that I was able to recruit patients from so many different institutions, and, specifically, to collect data from low-income respondents, whose voices are largely missing from research on women's experiences of pregnancy, birth and early parenting. Instrumental to the task of data recruitment was my wonderful team of undergraduate apprentices from U.C. Berkeley. Kirsten Anderson, Melissa Cervantes, Janet Hurtado, Aly Kronick, Jackline Lasola, Stacy Songco, and Christina Vargas were dedicated, resourceful, and professional. They collected a great deal of the survey data, including all of the data from our Spanish-speaking respondents. After data collection was done, Keli Benko and Kelly Stoering came on board to help organize and code the copious interview data. I am grateful for the capable work, intellectual curiosity, and great enthusiasm that these nine apprentices brought to the project. It was truly a joy to work with them. I feel fortunate to have received such insightful and enjoyable faculty support during my time at U.C. Berkeley. I thank my chair, Ann Swidler, for her tireless enthusiasm about this project. Her faith that it was interesting and important buoyed me many more times than she knows. I am grateful to have had the chance to have worked so closely with Arlie Hochschild, who served on