What does childbearing do to the body and the economy? The winners of the Vuoden Tiedekynä Academic Writing Award delve into postpartum ailments, the cost of which no one has calculated 

The body and mind of a person who gives birth carry the traces of pregnancy and childbirth throughout life, and this also has economic implications, argue Anna Rajala and Tiina Vaittinen, recipients of the Vuoden Tiedekynä Academic Writing Award. Since there is no longitudinal data on the costs of health issues caused by childbearing, the researchers created a fictional character, ‘Annastiina’, to illustrate  the long-term consequences of postpartum incontinence to both individuals and society as a whole. 

The body and mind of a person who gives birth carry the traces of pregnancy and childbirth throughout life, and this also has economic implications, as noted in a research article by Anna Rajala and Tiina Vaittinen, awarded the Vuoden Tiedekynä Academic Writing Award. Kone Foundation has granted the €25,000 award to Rajala and Vaittinen for their article, “The Political Economy of Reproductive Organs: On the Costs of Biological Reproduction at the Vaginal Interfaces of Political Economy.” The article was published in the special issue on the politics of care in the journal Poliittinen talous (10:2022). 
 
In political discourse, childbirth has been seen as the production of new taxpayers, i.e., the biological reproduction of the workforce. However, Rajala and Vaittinen, writing under the joint pseudonym Annastiina Rajala-Vaittinen, focus their attention not on the children being born, but on those who give birth and—breaking taboos in academic social science research—on the reproductive organs in particular.  
 
The authors highlight how childbirth depletes the body and leaves its mark on the mind of the person who gave birth.  
 
This is why it has an impact on both personal life and the national economy. In their award-winning article, the researchers ask how the well-being of vaginal people is taken care of in the public economy—on whose terms and at whose expense. 

The long-lasting effects of childbirth: the political economy of the reproductive organs 

“All economic systems have vaginal limits,” Rajala and Vaittinen summarize the main argument of their article. 

“Childbirth is the only biological event related to economic renewal that regularly tears and stretches the human body,” they write.  

Rajala and Vaittinen highlight the contradiction that, even though Finland as well as most Western countries  want new taxpayers to maintain its declining welfare state, society as a whole does not take responsibility for the physical and psychological effects of childbirth.  

“Vaginas are not just economic commodities and instruments of reproduction. Their well-being and ill-being are intimately linked not only to the well-being of vaginal people, but also to the sustainability of public finances.” 

Childbearing has lasting effects on the body of the person who gives birth, leaving traces far into life. In the article, Rajala and Vaittinen particularly highlight incontinence caused by pregnancy and childbirth. According to international estimates, one in three individuals who give birth vaginally experiences urinary incontinence, and up to one in ten faces faecal incontinence. 

The article takes a feminist approach: “Incontinence may be the most natural thing in the world when giving birth to a new human being, but there is nothing natural about not treating it.” 

“Incontinence in those who have given birth is an issue where public finances could be improved without making cuts. It can be prevented if pregnant people and people who have given birth are offered pelvic floor physiotherapy services, for example. However, if the condition is not treated at a young age, mild incontinence can worsen with age and accumulate human, economic, and environmental costs throughout the life cycle,” the researchers explain the longer-term effects.

In older people, urinary or fecal incontinence affects, for example, the stage at which round-the-clock care is needed. 

The two researchers want to bring an economic perspective to this: what are the human and economic costs of childbirth? 

“It turned out to be quite tragic”: Annastiina’s fictional life story

In order to calculate the economic costs of incontinence or other health problems caused by pregnancy and childbirth, sufficiently long-term data would be needed.

“To estimate the costs accumulated over a lifetime, we would have needed longitudinal data collected over decades. Since it was not possible to obtain such data, we decided to use material gathered in an ongoing incontinence project at the time, along with other previous research. From this, we constructed a life course that might resemble the story of many who have given birth,” the authors explain.

The result was the fictional life story of Annastiina. In the story, Annastiina’s urinary incontinence first causes her to give up her previously enjoyable exercise habits, then her sex life withers away, she experiences marital problems, periods of depression and sick leave, and finally, upon reaching retirement age, she moves into a nursing home with round-the-clock care. She pays for the treatment of her ailments out of her own pocket at different stages of her life.

“It turned out to be quite tragic,” Rajala and Vaittinen laugh. “Of course, all this does not necessarily happen to one person, but the purpose of research-informed realistic fiction or academic prose is to create an overall picture of a possible life course.”

The researchers have noticed that the narrative method not only underpins the research but also feeds into it.
“When you write from someone’s perspective, you put yourself in their shoes. It makes you wonder what might happen to the character in the story based on previous research, and it also guides your research in finding the information needed to support the story.”

The purpose of the fictional story is also to provide input for further research.

“Now we should find a feminist health economist who would calculate the long-term economic costs of birth injuries, especially those that are treatable and preventable.”

Joint authorship as resistance to competition

The researchers wrote their award-winning article under a joint pen name that combines elements of both their first and last names. For them, this shared authorship name also serves as a form of resistance against the current academic environment, which emphasises competition over collaboration.

“Even if you write and publish entirely on your own, research is always the result of collaboration,” the authors explain their decision.

“Annastiina can do much more, is capable of much more, and dares to do much more than Tiina or Anna alone. Annastiina also has her own ORCID researcher ID and a career ahead of her,” Rajala and Vaittinen promise.

The purpose of the Vuoden Tiedekynä Academic Writing Award is to support scientific writing in Finnish and enhance its recognition. Established in 2010, the award is worth €25,000, making it one of Finland’s largest prizes for scientific writing. The recognition is alternately awarded each year to the author or authors of a Finnish-language article in the fields of humanities, social sciences, or environmental research.

Award criteria, Professor of Sociology at the University of Eastern Finland, Ilpo Helén:

“The writing duo lays bare the costs and other economic impacts of overlooked deficiencies and neglect in women’s healthcare, challenging the reader to confront these realities. They take an unorthodox approach to economics and compellingly demonstrate that public healthcare has poorly and negligently addressed a significant issue in reproductive health: postpartum incontinence, including urinary and faecal leakage. The authors boldly and unapologetically infuse their writing with feminism, offering a refreshing perspective by focusing on the lived experience of embodied womanhood in the context of reproduction and childbirth, with a specific focus on the vagina as a reproductive organ. Intellectually, the article is not only robust but also exceptionally rich.”