Haith-Cooper Melanie, Bradshaw Gwendolen
Division of Midwifery and Reproductive Health, School of Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, United Kingdom.
Nurse Educ Today. 2013 Aug;33(8):772-7. doi: 10.1016/j.nedt.2012.06.014. Epub 2012 Jul 17.
Pregnant women seeking asylum in the United Kingdom appear particularly vulnerable, having complex health and social care needs and could benefit from a woman centred approach to midwifery care. This article is the second of three parts and reports on the findings from one objective of a wider doctorate study. It focuses on exploring midwifery students' perceptions of how to approach the care of pregnant women seeking asylum. Although the design of the study is explored in article one, in this context, the data was subject to critical discourse analysis to meet this objective. Key words and phrases were highlighted which appeared to reveal power and ideology implicit in the language used when discussing midwifery care of the pregnant woman seeking asylum. Dominant discourses were identified which appeared to influence the way in which care was approached and the possible sources of these discourses critically analysed. The findings suggest an underpinning ideology around following policies and guidelines to meet the physical needs of the woman at the expense of her other holistic needs. Despite learning to adopt a woman centred approach in theory, once in practice some students appear to be socialised into (re)producing these dominant medical and managerial discourses with "midwifery discourse" being marginalised. In addition, some students appeared to have difficulty understanding how to adopt a woman centred approach and the importance of considering the woman's context and its impact on care. These findings have implications for midwifery educators and this article identifies that the recent Nursing and Midwifery Council requirement for students to undertake a caseloading activity could provide the opportunity for them to adopt a consistent woman centred approach in practice, rejecting dominant medical and managerial discourses. However, these discourses appear to influence midwives caring for women more widely and will be difficult to challenge.
在英国寻求庇护的孕妇显得格外脆弱，她们有着复杂的健康和社会护理需求，而以女性为中心的助产护理方式可能会让她们受益。本文是三篇系列文章中的第二篇，报告了一项更广泛的博士研究中一个目标的研究结果。它着重探讨助产专业学生对于如何为寻求庇护的孕妇提供护理的看法。尽管研究设计在第一篇文章中已有探讨，但在此背景下，为实现这一目标，对数据进行了批判性话语分析。突出了一些关键词和短语，它们似乎揭示了在讨论为寻求庇护的孕妇提供助产护理时所用语言中隐含的权力和意识形态。识别出了一些主导性话语，这些话语似乎影响了护理的提供方式，并对这些话语的可能来源进行了批判性分析。研究结果表明，存在一种潜在的意识形态，即遵循政策和指导方针以满足女性的身体需求，却牺牲了她们的其他整体需求。尽管学生们在理论上学会了采用以女性为中心的方法，但在实践中，一些学生似乎被社会化，从而（重新）产生了这些主导性的医学和管理话语，而“助产话语”则被边缘化。此外，一些学生似乎难以理解如何采用以女性为中心的方法以及考虑女性背景及其对护理的影响的重要性。这些研究结果对助产教育工作者具有启示意义，本文指出，护理及助产士理事会最近要求学生开展个案管理活动，这可能为他们在实践中采用一致的以女性为中心的方法提供机会，摒弃主导性的医学和管理话语。然而，这些话语似乎更广泛地影响着照顾女性的助产士，且难以被挑战。
