Department of Nursing, Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia.
Department of Sociology, Faculty of Arts, University of Maribor, Koroška cesta 160, 2000 Maribor, Slovenia.
Women Birth. 2019 Apr;32(2):e173-e181. doi: 10.1016/j.wombi.2018.06.018. Epub 2018 Jul 7.
Pregnancy and childbirth hold broader cultural and societal implications and entail more than simply a natural event. Today, these otherwise natural phenomena are driven by the development of surveillance medicine in a risk-averse society. This affects how both healthcare professionals and women perceive medicalisation and is influencing changes in clinical practice surrounding childbirth.
The aim of the study was to explore the phenomenon of the medicalisation of pregnancy and childbirth in Slovenia as perceived and experienced by healthcare professionals, namely midwives and obstetricians.
A descriptive phenomenological approach was used. A purposive sample included 16 midwives and 4 obstetricians working in perinatal healthcare. The data were collected using in-depth, semi-structured, one-to-one interviews and analysed using the phenomenological methodology approach proposed by Colaizzi.
The two professional groups are well aware of the medicalisation of pregnancy and childbirth, yet there are some differences in experiencing these phenomena. This is revealed with respect to three identified themes: (1) medicalisation as a social construct; (2) unrecognised importance of evidence-based practice in changing medicalised care; and (3) the dimensionalities of the Caesarean section.
Our study suggests woman-centred care that supports autonomy should be more strongly promoted and strategies supporting women with different childbirth preferences developed. The findings also show interprofessional collaboration should be further explored since midwives' autonomy and participatory decision-making in clinical settings is encountering some unresolved issues within the scope of midwifery practice that affect their professionalism.
妊娠和分娩具有更广泛的文化和社会意义,不仅仅是自然事件。如今,这些自然现象受到风险规避社会中监控医学的发展的推动。这影响了医疗保健专业人员和女性对医学化的看法,并正在影响围绕分娩的临床实践的变化。
本研究旨在探索斯洛文尼亚妊娠和分娩医学化的现象,即助产士和妇产科医生的感知和体验。
采用描述性现象学方法。目的抽样包括在围产期保健工作的 16 名助产士和 4 名妇产科医生。使用深入的、半结构化的一对一访谈收集数据,并使用 Colaizzi 提出的现象学方法进行分析。
两个专业群体都非常清楚妊娠和分娩的医学化,但在体验这些现象方面存在一些差异。这体现在三个已确定的主题中:(1)医学化作为一种社会建构;(2)循证实践在改变医学化护理方面的未被认识到的重要性;以及(3)剖宫产的维度。
我们的研究表明,应更大力提倡以妇女为中心的支持自主权的护理,并制定支持具有不同分娩偏好的妇女的策略。研究结果还表明,应进一步探索跨专业合作,因为助产士在临床环境中的自主权和参与决策遇到了一些在助产实践范围内未解决的问题,这影响了她们的专业精神。