Journal of Research in Nursing and Midwifery (original) (raw)
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Title: Barriers to Midwifery: An International Perspective
Research consistently demonstrates that midwives offer effective care. Not only is midwife care less expensive than physician care, midwives are often able to establish a rapport with clients that translates into better perinatal health for mothers and babies. Given its effectiveness and efficiency, it is odd that the practice of midwifery is still limited in many places in the world. In some places midwives face legal restrictions; in other places midwives are limited by the nature of medical practice or by other cultural and social factors. When attempting to improve primary care in obstetrics, one must understand the barriers faced by midwives. Although there exist several social scientific accounts of midwives, no one has collated these works in a way that allows us to see reasons for the great variation in the practices of midwives. The purpose of this paper is to provide an analysis of the social situation of midwives. To that end, how the different approaches to midwifery evolved (and are evolving) are explored. The effects of different organizational structures and how different cultures influence midwives' niches in the health care system, the way midwives view their profession, how midwives do their work, and how midwives are viewed by others are also examined. DESCRIPTIONS OF MIDWIFERY around the world are provided by anthropologists, sociologists, and others. To compare these accounts is to be struck by the great diversity in the status of midwives. While midwives in different cultures share the common tasks of assisting at birth and caring for the health of women, they do not share a common status. In some cultures people genuflect and kiss the hand of a midwife when she passes [ 1]; in other places midwives are seen as "polluted" [ 2]; in still other cultures midwives are accorded the middling status of "semiprofessional." These accounts also reveal a wide diversity in recruitment, training, styles of practice, the midwife's place in the community and in the medical system, and the rewards of practice. If midwives were organized along a continuum, with those who use all the tools of modern technology at one end and those who are nontechnological in orientation at the other, those on the extreme ends of the continuum would not recogn ize each other as
Midwifery: women, history and politics
Much has been made of evidence-based practice in health care and in particular, in maternity care. Numerous studies have indicated that small maternity units plus midwifery, as a primary health care practice, is best for the physical and emotional health of the majority of childbearing women and their babies. However, despite various state and federal government reports recommending midwifery led care and a flurry of Alternative Birthing Services pilot programs in the early 1990s, Australian governments and health care organisations have not generally shifted from a medically dominated approach to a social health model for maternity care provision. History suggests that to do so conflicts with the professional and economic interests of medicine. This paper explores the history, the politics and women's place in society within a midwifery context, so that midwives have a wider perspective on contemporary issues associated with midwifery practice. Such a broad view will enable newer members of the midwifery profession to recognise that the current negativity from some medical colleagues about moves to increase midwifery-led options for childbearing women and the associated midwifery autonomy have long standing historical and political roots. Such an understanding will help make sense of the current political and practice landscape. (author abstract)
Daughter of time: the postmodern midwife (part 2)
Revista da Escola de Enfermagem da U S P, 2008
Any effort to make sense of the complexities of contemporary midwifery must deal not only with biomedical and governmental power structures but also with the definitions such structures impose upon midwives and the ramifications of these definitions within and across national and cultural borders. The international definition of a midwife requires graduations from a government-recognized educational program. Those who have not are not considered midwives but are labeled traditional birth attendants. Since there are myriad local names for midwives in myriad languages, the impact of this naming at local levels can be hard to assess. But on the global scale, the ramifications of the distinction between midwives who meet the international definition and those who do not have been profound. Those who do are incorporated into the health care system. Those who do not remain outside of it, and suffer multiple forms of discrimination as a result.
An exploratory metasynthesis of midwifery practice in the United States
Midwifery, 2003
Objectives: to conduct a metasynthesis of six qualitative studies of midwifery care and process; identify common themes and metaphors among the six studies for further exploration and theory development; and create a framework for further metasynthesis of qualitative studies of midwifery practice in the USA.
Community Based Midwives Practice in Patriarchal Social System
2015
It is well accepted globally, that midwives can save the lives of mothers and their newborn successfully, if the community stakeholders provide support and freedom for full scope of practice. Recognising this many countries deploy midwives in the community as an intervention to achieve the MDGs (Millennium Development Goals) 4 and 5 targets set for decreasing maternal and neonatal mortality, respectively. However, high-income countries’ reports show very good results, in achieving MDGs 4 and 5 while the low-income countries lag behind in this regard. The situation in highincome and low-income countries is different because midwives practising in the community in low-income countries face many barriers. These barriers include a lack of understanding of midwives’ role, inadequate logistic arrangements, patriarchy, culture, and norms at the level of the family and society that affect all CMWs’ (Community Midwives) lives as women.
Midwives and social change in France
Modern midwifery emerged in France during the 15th century. This profes- sion has witnessed numerous changes in its responsibilities, legal status and social representations. All of these transformations occurred in parallel to so- cial changes and major shifts in French reproductive healthcare. This study examines midwifery over the past few centuries in order to provide a better understanding of parental behaviour and the social characteristics of birth. The approach employed in this article combines a historical perspective with a sociological analysis. This socio-historical study reveals not only how mid- wives have helped women assert their individual rights as mothers but also how parents have supported the demands of midwives for the improved so- cial and legal recognition of their profession. The combined action of mid- wives and parents are changing the French reproductive health system, both by transforming birth procedures within hospitals and by asserting the right to gi...
Journal of Modern Nursing Practice and Research
Task-shifting from doctors to midwives/nurse-midwives is not a novel human resources strategy but an evidence-based return to the origins of women's care in pregnancy, birth, and the postpartum period. Many countries still rely on medical-led care models to care for women at low risk of complications despite solid evidence that midwifery models result in better outcomes for women and babies. This commentary reflects on how historically women have been cared for by midwives and how a patriarchal and medicalized culture interfered negatively in a physiological life event.
Choice, continuity and control: changing midwifery, towards a sociological perspective
Midwifery, 1995
In this paper sociological theories of the professions and the organisation of work are drawn on to explain current developments in the organisation of maternity care. Utilising the literature on the sociology of the professions and general trends in health policy and labour markets, possible reasons for the current renaissance in midwifery and some implications for midwives are discussed. Thus, whilst some women and midwives may be building a paradigm of 'womancentred' practice based on an equal partnership, for other midwives, the result may be a divided workforce consisting of an elite core and casualised periphery based on the ability to give a full-time flexible commitment to work. The implications of excluding those midwives who are unable to combine fulltime work with their own domestic commitments are discussed.