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Book part
Publication date: 18 September 2018

Jessica Liddell and Katherine M. Johnson

There is extensive research documenting the physical outcomes of childbirth, but significantly less on socio-psychological outcomes. Investigating women’s perception of…

Abstract

Purpose

There is extensive research documenting the physical outcomes of childbirth, but significantly less on socio-psychological outcomes. Investigating women’s perception of dignified treatment during birth contributes to a salient, under-examined aspect of women’s childbirth experiences.

Methodology/approach

We use a two-part conceptualization of dignity, respect and autonomy, to understand how birth experiences and interactions either facilitate or undermine women’s perceived dignity. Data came from the Listening-to-Mothers I survey, the first nationally representative study of postpartum women in the United States (n = 1,406). Through linear regression analysis, we separately modeled women’s perception of respectful treatment and women’s perception of medical autonomy during birth.

Findings

Overall women reported high scores for both autonomy and respect. Differences between the models emerged related primarily to the role of interventions and provider support. While women’s perceived dignity is related to elements that she brings in to the delivery room (e.g., birth knowledge, health status), much variation was explained by the medical encounter itself (e.g., type of medical interventions, pain management, nurse support, and number of staff present).

Research limitations/implications

This study is cross-sectional, and required either a telephone or internet access, thus limiting the full generalizability of findings. Two findings have direct practical relevance for promoting women’s dignity in childbirth. First, the number of staff persons present during labor and birth was negatively associated with both respect and autonomy. Second, that women with high levels of knowledge about their legal rights during childbirth were more likely to report high scores on the dignity scale. Limiting staff in the delivery room and including knowledge of legal rights in childbirth education or during prenatal visits may be two mechanisms to promote dignity in birth.

Originality/value

These findings address an important, under-examined aspect of women’s childbirth experiences. This study investigates how different birth experiences and interactions either promote or violate childbearing women’s perception of dignity, and has significant implications for the provision of maternal healthcare. The results reinforce the importance of focusing on the socio-psychological dimensions of childbirth.

Details

Gender, Women’s Health Care Concerns and Other Social Factors in Health and Health Care
Type: Book
ISBN: 978-1-78756-175-5

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Book part
Publication date: 22 November 2019

Kellie Owens

As maternal mortality increases in the United States, birth providers and policymakers are seeking new solutions to address what scholars have called the “C-section…

Abstract

As maternal mortality increases in the United States, birth providers and policymakers are seeking new solutions to address what scholars have called the “C-section epidemic.” Hospital cesarean rates vary tremendously, from 7 to 70 percent of all births. Based on in-depth, semi-structured interviews with 47 obstetricians and family physicians in the United States, I explore one reason for this variation: differences in how physicians perceive and manage risk in American obstetrics. While the dominant model of risk management encourages high levels of intervention and monitoring, I argue that a significant portion of physicians are concerned about high intervention rates in childbirth and are working to reduce cesarean rates and/or the use of monitoring technologies like continuous fetal heart rate monitors. Unlike prior theories of biomedicalization, which suggest that health risks are managed through increased monitoring and intervention, I find that many physicians are resisting this model of risk management by ordering fewer interventions and collecting less information about their patients. These providers acknowledge that interventions designed to mitigate risks may only provide an illusion of control, rather than an actual mastery of risks. By limiting interventions, providers may lose this illusion of control but also mitigate the iatrogenic effects of intervention and continuous monitoring. This alternative approach to risk management is growing in many medical fields and deserves more attention from medical sociologists.

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Reproduction, Health, and Medicine
Type: Book
ISBN: 978-1-78756-172-4

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Book part
Publication date: 22 November 2019

Katherine M. Johnson, Richard M. Simon, Jessica L. Liddell and Sarah Kington

There has been substantial interest in US cesarean rates, which increased from 5% of deliveries in the 1970s to nearly one-third of births by the mid-2000s. Explanations…

Abstract

There has been substantial interest in US cesarean rates, which increased from 5% of deliveries in the 1970s to nearly one-third of births by the mid-2000s. Explanations typically emphasize individual risk factors (e.g., advanced maternal age, increased BMI, and greater desire for control over delivery) of women giving birth, or address institutional factors, such as the medicalization of childbirth and the culture of liability leading physicians to practice defensive medicine. We focus here on another non-medical explanation – childbirth education (CBE). CBE is an important, underexplored mechanism that can shape women’s expectations about labor and birth and potentially lead them to expect, or desire, a cesarean delivery as a normalized outcome. We analyze data from three waves (2002, 2006, 2013) of the Listening to Mothers national survey on US women’s childbearing experiences (n = 3,985). Using logistic regression analysis, we examined both mode of delivery (vaginal versus cesarean), and attitudes about future request for elective cesarean among both primiparous and multiparous women. Despite previous research suggesting that CBE increased the likelihood of vaginal delivery, we find that CBE attendance was not associated with likelihood of vaginal delivery among either primiparous or multiparous women. However, both primiparous and multiparous women who attended CBE classes were significantly more likely to say they would request a future, elective cesarean. Furthermore, these effects were in the opposite direction of effects for natural birth attitudes. Our findings suggest that contemporary CBE classes may be a form of “anticipatory socialization”, potentially priming women’s acceptance of medicalized childbirth.

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Book part
Publication date: 25 November 2019

Zehra Zeynep Sadıkoğlu

Turkish mothers’ interactions with medical authorities during pregnancy and childbirth have developed in a context of risk discourses produced by biomedical experts with…

Abstract

Turkish mothers’ interactions with medical authorities during pregnancy and childbirth have developed in a context of risk discourses produced by biomedical experts with surveillance justified by these discourses. Giving meaning to pregnancy and childbirth through the search for the reduction of risks is a reflexive part of Turkish mothers’ everyday life.

This research paper aims to discuss a study examining how pregnancy and childbirth are socially constructed, how increased medicalization is experienced by Turkish mothers, and how they assign meaning to pregnancy and childbirth. A phenomenological research was designed using depth interviews with 10 Turkish mothers with children aged 0–6 years, living in Istanbul who had high education and welfare levels.

The findings shed light on Turkish mothers’ subjective experiences and how medicine as a profession shapes these experiences. With the medicalization of pregnancy and childbirth, how the trust toward the experts, the knowledge of preparation for maternity in an appropriate and responsible manner have become functional for Turkish mothers to create a sense of ontological security are examined.

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Childbearing and the Changing Nature of Parenthood: The Contexts, Actors, and Experiences of Having Children
Type: Book
ISBN: 978-1-83867-067-2

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Book part
Publication date: 30 June 2004

Terri A Winnick

Language is a fundamental and yet extraordinarily powerful medium. Language is more than the primary feature distinguishing humans from other species. As our principle…

Abstract

Language is a fundamental and yet extraordinarily powerful medium. Language is more than the primary feature distinguishing humans from other species. As our principle means of communication, language links us to culture, and in so doing, shapes our perceptions and determines the way in which we think (Clark, Eschholz & Rosa, 1981; Thorne, Kramarae & Henley, 1983). Language is inseparable from social life. Through language, individuals learn cultural patterns and political and social values (Mueller, 1973). Language also reflects the prejudices of society, with assumptions about relative status, power or appropriate behavior often built into the words we use to talk about different groups of people. As Frank and Anshen (1983) note, ageism, racism, and most importantly for this discussion, sexism, are all perpetuated by our language, even among those who consciously reject those prejudices.

Details

Gendered Perspectives on Reproduction and Sexuality
Type: Book
ISBN: 978-0-76231-088-3

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Article
Publication date: 8 June 2021

Carla V. Leite and Ana Margarida Almeida

This research proposes a framework to guide the development and analysis of digital interventions, namely, through mobile applications, regarding labor and birth. By…

Abstract

Purpose

This research proposes a framework to guide the development and analysis of digital interventions, namely, through mobile applications, regarding labor and birth. By complying with current scientific evidence, this paper aims to contribute to the safeness and completeness of perinatal health education targeting expectant parents.

Design/methodology/approach

A content analysis was conducted on a document containing World Health Organization guidelines for intra-partum, considering the following categories: timeframe, care options, category of recommendation, to create a data set clearly distinguishing between recommendations and non-recommendations. Context-specific and research-context recommendations, details from dosages, measurements and timings, infant care and non-immediate postpartum topics were considered out of the scope of this study.

Findings

The results were summarized in a table, ready to be used as a data set, including the following 16 care options ranging from health, well-being and/or rights: respect, communication, companionship, pregnant person’s monitoring, status, fetal monitoring, pain relief, pain management, amenities, labor delay prevention, progress, freedom of choice, facilitation of birth, prevention of postpartum hemorrhage, umbilical cord care and recovery. These were distributed across six timeframes: always, admission, first, second and third stage of labor and immediate postpartum. In addition, recommendations and non-recommendations are displayed in different columns.

Originality/value

This transdisciplinary research intends to contribute to: future research on perinatal education; the creation of digital interventions, namely, m-health ones, targeting expectant parents by providing a framework of content coverage; the endorsement of the rights to Information and to decision-making. Ultimately, when put into practice, the framework can impact self-care through access to perinatal education.

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Abstract

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Reproduction, Health, and Medicine
Type: Book
ISBN: 978-1-78756-172-4

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Book part
Publication date: 10 August 2017

Miriam Naiman-Sessions, Megan M. Henley and Louise Marie Roth

This research examines effects on emotional burnout among “maternity support workers” (MSWs) that support women in labor (labor and delivery (L&D) nurses and doulas). The…

Abstract

This research examines effects on emotional burnout among “maternity support workers” (MSWs) that support women in labor (labor and delivery (L&D) nurses and doulas). The emotional intensity of maternity support work is likely to contribute to emotional distress, compassion fatigue, and burnout.

This study uses data from the Maternity Support Survey (MSS) to analyze emotional burnout among 807 L&D nurses and 1,226 doulas in the United States and Canada. Multivariate OLS regression models examine the effects of work–family conflict, overwork, emotional intelligence, witnessing unethical mistreatment of women in labor, and practice characteristics on emotional burnout among these MSWs. We measure emotional burnout using the Professional Quality of Life (PROQOL) Emotional Burnout subscale.

Work–family conflict, feelings of overwork, witnessing a higher frequency of unethical mistreatment, and working in a hospital with a larger percentage of cesarean deliveries are associated with higher levels of burnout among MSWs. Higher emotional intelligence is associated with lower levels of burnout, and the availability of hospital wellness programs is associated with less burnout among L&D nurses.

While the MSS obtained a large number of responses, its recruitment methods produced a nonrandom sample and made it impossible to calculate a response rate. As a result, responses may not be generalizable to all L&D nurses and doulas in the United States and Canada.

This research reveals that MSWs attitudes about medical procedures such as cesarean sections and induction are tied to their experiences of emotional burnout. It also demonstrates a link between witnessing mistreatment of laboring women and burnout, so that traumatic incidents have negative emotional consequences for MSWs. The findings have implications for secondary trauma and compassion fatigue, and for the quality of maternity care.

Details

Health and Health Care Concerns Among Women and Racial and Ethnic Minorities
Type: Book
ISBN: 978-1-78743-150-8

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Book part
Publication date: 18 September 2018

Abstract

Details

Gender, Women’s Health Care Concerns and Other Social Factors in Health and Health Care
Type: Book
ISBN: 978-1-78756-175-5

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Article
Publication date: 7 July 2020

Şirin Özkan, Chifa Chiang, Gökhan Aba and Yusuf Çelik

The purpose of this study was to determine the satisfaction of women who underwent normal delivery and cesarean section (or C-section) with maternal care in five state-run…

Abstract

Purpose

The purpose of this study was to determine the satisfaction of women who underwent normal delivery and cesarean section (or C-section) with maternal care in five state-run hospitals in Northwestern Turkey.

Design/methodology/approach

This was a cross-sectional study. The sample consisted of 580 women who underwent normal delivery (ND) and 392 who had a C-section (CS). Data were collected using two maternal satisfaction questionnaires, which participants completed right before they were discharged.

Findings

More than half of ND (61.7%) and CS (56.9%) participants were satisfied with maternal care. ND participants who had received antenatal training were more satisfied with maternal care than CS participants who had not received antenatal training. Higher income was a significant predictor for reduced satisfaction with maternal care among CS participants (p = 0.031).

Practical implications

Hospital administrators and decision-makers should meet women's expectations, provide them with comfort, encourage them for skin-to-skin contact and respect their right to privacy in order to increase their satisfaction with maternal care. Pregnant women should also be encouraged to receive antenatal training offered by hospitals before delivery.

Originality/value

The evidence-based results of the study will help hospital administrators to improve healthcare quality and focus on increasing women's satisfaction with maternal care.

Details

International Journal of Health Care Quality Assurance, vol. 33 no. 4/5
Type: Research Article
ISSN: 0952-6862

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