Document Detail


A metasynthesis of midwives' experience of hospital practice in publicly funded settings: compliance, resistance and authenticity.
MedLine Citation:
PMID:  19841021     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Worldwide, increasing percentages of women are giving birth in centralized hospitals in the belief that this maximizes safety for themselves and their babies. In parallel, there is international recognition that the number of birth interventions used in the routine care of labouring women is rising. This is fuelling concern about iatrogenesis, and, particularly, maternal and infant morbidity and mortality. It also has an adverse impact on the economics of health care. National and international policy characterizes midwives as the guardians of normal childbirth. This guardianship appears to be failing. The objective of this metasynthesis is to explore midwives' perceptions of hospital midwifery with a focus on labour ward practice to examine professional discourses around midwifery work in the current modernist, risk averse and consumerist childbirth context. Based on an iterative search strategy, 14 studies were selected for the metasynthesis. Three overarching themes were identified: 'power and control'; 'compliance with cultural norms'; and 'attempting to normalize birth'. Most midwives aimed to provide what they characterized as 'real midwifery' but this intention was often overwhelmed with heavy workloads and the normative pressure to provide equitable care to all women. This raises questions of authenticity, both in terms of midwives living out their beliefs, and in terms of acknowledgement of the power to resist. The theoretical insights generated by the metasynthesis could have resonance for other professional and occupational groups who wish to offer autonomous individualized services in an increasingly risk-averse target driven global society.
Authors:
Rhona O'Connell; Soo Downe
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Health (London, England : 1997)     Volume:  13     ISSN:  1363-4593     ISO Abbreviation:  Health (London)     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-20     Completed Date:  2009-12-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9800465     Medline TA:  Health (London)     Country:  England    
Other Details:
Languages:  eng     Pagination:  589-609     Citation Subset:  IM    
Affiliation:
University of Central Lancashire, Preston, UK. r.oconnell@ucc.ie
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Culture*
Delivery Rooms
Female
Great Britain
Hospitals, Public*
Humans
Midwifery*
Pregnancy
Professional Autonomy*
Review Literature as Topic

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Enacting death in the intensive care unit: medical technology and the multiple ontologies of death.
Next Document:  Identities under construction: Women hailed as addicts.