The marginalisation of midwifery in medicalised pregnancy and childbirth: a qualitative study

02 November 2020
17 min read
Volume 28 · Issue 11

Abstract

Introduction

The role of midwives has changed in providing care for low-risk pregnancies and childbirth. This study explores the perceptions of perinatal care providers and recipients regarding midwifery services.

Methods

This study used a qualitative content analysis approach. Data were collected through 49 semi-structured in-depth interviews, and analysed with qualitative content analysis.

Results

The medicalisation of pregnancy and childbirth has marginalised midwifery. Midwifery, which should be at the heart of all low-risk pregnancies and childbirth, has deteriorated such that it has become disempowered in interdisciplinary relations.

Conclusions

Midwifery is at risk of being totally excluded from low-risk pregnancy care and childbirth.

In many places across the globe, midwives are the first caregivers of pregnant women and parturient (Sandall et al, 2016). Nonetheless, significant differences exist in the organisation of midwifery services, education and roles (Sandall et al, 2016; Enkin et al, 1995), and pregnant women are often faced with different options that render it difficult to identify the best choice (Enkin et al, 1995; Moghasemi et al, 2018). The midwifery model of care and the medical model follow different approaches to pregnancy care provision and childbirth. These approaches can culminate in a complementary outlook that causes favorable midwife–physician interactions. However, important differences exist between the two models, such as differences in philosophy, interactions between provider and pregnant woman, focus in prenatal care, use of childbirth interventions and other facets of care during labor, and the objectives of care (Rooks, 1999; Bryers and Van Teijlingen, 2010).

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