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Martín-Badia J, Obregón-Gutiérrez N, Goberna-Tricas J. Obstetric Violence as an Infringement on Basic Bioethical Principles. Reflections Inspired by Focus Groups with Midwives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312553. [PMID: 34886279 PMCID: PMC8656655 DOI: 10.3390/ijerph182312553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 11/22/2022]
Abstract
Background: obstetric violence is still far too invisible; the word “violence” generates rejection and obstetric violence is complex to define and typify, as it is a subjective experience. It has been widely analyzed from legal, sociological, and clinical perspectives, but not equally so from the bioethical point of view. This article sets out to take a more in-depth look at the experiences of midwives in order to describe the ethical perspectives of obstetric violence. We intend to describe the effects that malpractice and violence within obstetric care have on American and European bioethical principles. Methodology: A qualitative methodology of the phenomenological tradition was used: 24 midwives participated in three focus groups. Results and Discussion: four categories were arrived at; they are “the maleficence of forgetting my vulnerability”, “beneficence requires respect for my integrity and dignity”, “my autonomy is being removed from me” and “a problem of social justice towards us, women”. Conclusion: obstetric violence infringes on the main bioethical principles (non-maleficence, beneficence, autonomy, justice, vulnerability, dignity, and integrity). Beyond whether it is called violence or not, what matters from an ethical perspective is that, as long as women have such negative experiences during pregnancy and childbirth, obstetric care needs better humanizing.
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Affiliation(s)
- Júlia Martín-Badia
- Department of Philosophy, University of Barcelona, 08001 Barcelona, Spain;
| | - Noemí Obregón-Gutiérrez
- University Hospital Parc Taulí, Sabadell, 08208 Barcelona, Spain;
- The Nursing Council of Barcelona, 08019 Barcelona, Spain
| | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, ADHUC–Research Center for Theory, Gender and Sexuality, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-934021068
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Colomar M, Opiyo N, Kingdon C, Long Q, Nion S, Bohren MA, Betran AP. Do women prefer caesarean sections? A qualitative evidence synthesis of their views and experiences. PLoS One 2021; 16:e0251072. [PMID: 33951101 PMCID: PMC8099111 DOI: 10.1371/journal.pone.0251072] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/19/2021] [Indexed: 11/19/2022] Open
Abstract
Background Caesarean sections (CS) continue to increase worldwide. Multiple and complex factors are contributing to the increase, including non-clinical factors related to individual women, families and their interactions with health providers. This global qualitative evidence synthesis explores women’s preferences for mode of birth and factors underlying preferences for CS. Methods Systematic database searches (MEDLINE, EMBASE, CINAHL, PsycINFO) were conducted in December 2016 and updated in May 2019 and February 2021. Studies conducted across all resource settings were eligible for inclusion, except those from China and Taiwan which have been reported in a companion publication. Phenomena of interest were opinions, views and perspectives of women regarding preferences for mode of birth, attributes of CS, societal and cultural beliefs about modes of birth, and right to choose mode of birth. Thematic synthesis of data was conducted. Confidence in findings was assessed using GRADE-CERQual. Results We included 52 studies, from 28 countries, encompassing the views and perspectives of pregnant women, non-pregnant women, women with previous CS, postpartum women, and women’s partners. Most of the studies were conducted in high-income countries and published between 2011 and 2021. Factors underlying women preferences for CS had to do mainly with strong fear of pain and injuries to the mother and child during labour or birth (High confidence), uncertainty regarding vaginal birth (High confidence), and positive views or perceived advantages of CS (High confidence). Women who preferred CS expressed resoluteness about it, but there were also many women who had a clear preference for vaginal birth and those who even developed strategies to keep their birth plans in environments that were not supportive of vaginal births (High confidence). The findings also identified that social, cultural and personal factors as well as attributes related to health systems impact on the reasons underlying women preferences for various modes of birth (High confidence). Conclusions A wide variety of factors underlie women’s preferences for CS in the absence of medical indications. Major factors contributing to perceptions of CS as preferable include fear of pain, uncertainty with vaginal birth and positive views on CS. Interventions need to address these factors to reduce unnecessary CS.
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Affiliation(s)
- Mercedes Colomar
- Montevideo Clinical and Epidemiological Research Unit, Montevideo, Uruguay
- * E-mail:
| | - Newton Opiyo
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Carol Kingdon
- School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu Province, China
| | - Soledad Nion
- Faculty of Social Sciences, Sociology Department, Universidad de la República (UdelaR), Montevideo, Uruguay
| | - Meghan A. Bohren
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
- Gender and Women’s Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Ana Pilar Betran
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Keser Özcan N, Boyacıoğlu NE, Güdücü N, Göncü Serhatlıoğlu S, Yıldırım E, Koç M, Bingol F. Turkish Midwifery Students' Fear of Delivery Process. J Caring Sci 2019; 8:121-127. [PMID: 31598504 PMCID: PMC6778309 DOI: 10.15171/jcs.2019.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/22/2018] [Indexed: 11/09/2022] Open
Abstract
Introduction: Fear affects a person’s decision-making process and causes a midwife to make a wrong decision about normal vaginal delivery and cesarean delivery, so research was carried out in order to determine the fields related to delivering process in which students experience the most fear and feel sufficient. Methods: A descriptive/cross-sectional study was performed between September and October 2017. The sample consisted of 732 students selected with the convenience maximum variation sampling method from six universities studying in the third and fourth years of a midwifery program. The study measured data collected with a questionnaire entitled “Midwives’ Fear of Delivery Process”. The data were analyzed in with the SPSS for Windows using percentage and mean values and Spearman correlation test. Results: In general, students are more afraid of practices with which they say they have more experience such as vaginal palpation (3.30 (0.884), rs=0.131, P<0.001), and they are less afraid of practices (interventional) with which they have less experience such as breech delivery (1.70 (0.915), rs=0.048, P=0.197) or no experience at all and of cases in which they can get hurt. The students feel most sufficient when performing prenatal and postnatal practices. Conclusion: The results of our study parallel the conclusion in the literature that students are afraid of the fields that they have practiced most. Before clinical practice, instructors can determine students’ fears and deficiencies in relation to procedures and areas of practice and can develop approaches for alleviating their fears and weaknesses.
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Affiliation(s)
- Neslihan Keser Özcan
- Department of Midwifery, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nur Elçin Boyacıoğlu
- Department of Midwifery, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Neriman Güdücü
- Department of Midwifery, Faculty of Health Sciences, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | | | - Emine Yıldırım
- Department of Midwifery, Faculty of Health Sciences, Omer Halisdemir University, Nigde, Turkey
| | - Medine Koç
- Department of Midwifery, Faculty of Health Sciences, Gaziosmanpasa University, Tokat, Turkey
| | - Fadime Bingol
- Department of Midwifery, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
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Teixeirense MMDS, Santos SLSD. From expectation to experience: humanizing childbirth in the Brazilian National Health System. INTERFACE - COMUNICAÇÃO, SAÚDE, EDUCAÇÃO 2018. [DOI: 10.1590/1807-57622016.0926] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
During the past 15 years Brazil has increased efforts to humanize maternal care within the Brazilian National Health System (SUS). Humanization efforts come along with de-medicalization of birth even if quality care and reduction of inequalities are still pressing matters in the country. For this qualitative study we interviewed ten women regarding their experiences of pregnancy and childbirth. The study took place in Brasília (DF) and women narrated their birth experiences at local hospitals or a birth center. Women were mostly satisfied with their attention during childbirth, specifically those giving birth at the birth center, in contrast to women giving birth at local hospitals. However, the humanization movement, essentializing women's bodies can also reproduce normative discourses that shape a sense of self-blame and disappointment if the ‘ideal birth is not achieved.
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Withers M, Kharazmi N, Lim E. Traditional beliefs and practices in pregnancy, childbirth and postpartum: A review of the evidence from Asian countries. Midwifery 2018; 56:158-170. [DOI: 10.1016/j.midw.2017.10.019] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 10/22/2017] [Accepted: 10/23/2017] [Indexed: 11/26/2022]
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Pintassilgo S, Carvalho H. Trends and consequences of the technocratic paradigm of childbirth in Portugal: A population-based analysis of birth conditions and social characteristics of parents. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 13:58-67. [DOI: 10.1016/j.srhc.2017.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/20/2017] [Accepted: 06/16/2017] [Indexed: 10/19/2022]
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Darra S, Murphy F. Coping and help in birth: An investigation into 'normal' childbirth as described by new mothers and their attending midwives. Midwifery 2016; 40:18-25. [PMID: 27428094 DOI: 10.1016/j.midw.2016.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/01/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE to investigate how 'normal' childbirth is described by new mothers and their attending midwives. DESIGN a qualitative, reflexive, narrative study was used to explore birth stories using in-depth, un-structured interviews. SETTING 21 new mothers and their 16 attending midwives were recruited from the locality surrounding a district general hospital in South Wales, United Kingdom (UK). FINDINGS the findings identified that the mothers wanted to cope with labour and birth, by breathing through it and using some birth interventions with the help of knowledgeable midwives. Midwives aimed to achieve 'normality' in birth but also commonly utilised birth interventions. Consequently the notion of 'normal' birth as not involving interventions in birth was not found to be a useful defining concept in this study. Furthermore, current dichotomous models and theories of birth and midwifery in particular those relating to pain management did not fully explain the perspectives of these women and their midwives. IMPLICATIONS FOR PRACTICE dichotomous models and theories for birth and midwifery practice and those which incorporate the term 'normal' birth are shown to be not entirely useful to fully explain the contemporary complexity of childbirth in the UK. Therefore it is now necessary to consider avoiding using dichotomous models of birth and midwifery in the UK and to instead concentrate on developing integrated models that reflect the real life current experiences of women and their midwives.
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Affiliation(s)
- Susanne Darra
- College of Human and Health Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom.
| | - Fiona Murphy
- Department of Nursing and Midwifery, University of Limerick, Castletroy, Limerick. Ireland
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Afraid of Delivering at the Hospital or Afraid of Delivering at Home: A Qualitative Study of Thai Hmong Families’ Decision-Making About Maternity Services. Matern Child Health J 2015; 19:2384-92. [DOI: 10.1007/s10995-015-1757-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Coxon K, Sandall J, Fulop NJ. To what extent are women free to choose where to give birth? How discourses of risk, blame and responsibility influence birth place decisions. HEALTH RISK & SOCIETY 2013. [DOI: 10.1080/13698575.2013.859231] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Behruzi R, Hatem M, Goulet L, Fraser W, Misago C. Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework. BMC Pregnancy Childbirth 2013; 13:205. [PMID: 24215446 PMCID: PMC3835545 DOI: 10.1186/1471-2393-13-205] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 11/05/2013] [Indexed: 11/30/2022] Open
Abstract
Understanding the main values and beliefs that might promote humanized birth practices in the specialized hospitals requires articulating the theoretical knowledge of the social and cultural characteristics of the childbirth field and the relations between these and the institution. This paper aims to provide a conceptual framework allowing examination of childbirth practices through the lens of an organizational culture theory. A literature review performed to extrapolate the social and cultural factors contribute to birth practices and the factors likely overlap and mutually reinforce one another, instead of complying with the organizational culture of the birth place. The proposed conceptual framework in this paper examined childbirth patterns as an organizational cultural phenomenon in a highly specialized hospital, in Montreal, Canada. Allaire and Firsirotu's organizational culture theory served as a guide in the development of the framework. We discussed the application of our conceptual model in understanding the influences of organizational culture components in the humanization of birth practices in the highly specialized hospitals and explained how these components configure both the birth practice and women's choice in highly specialized hospitals. The proposed framework can be used as a tool for understanding the barriers and facilitating factors encountered birth practices in specialized hospitals.
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Affiliation(s)
- Roxana Behruzi
- Department of Family Medicine, McGill University, Faculty of Medicine, Montreal, Canada
| | - Marie Hatem
- Department of Social and Preventive Medicine, Université de Montréal, Faculty of Medicine, Montreal, Canada
| | - Lise Goulet
- Department of Social and Preventive Medicine, Université de Montréal, Faculty of Medicine, Montreal, Canada
| | - William Fraser
- Department of Obstetrics and Gynecology, Université de Montréal, Faculty of Medicine, Montreal, Canada
| | - Chizuru Misago
- Department of International and Cultural Study, Tsuda College, Kodaira, Japan
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Lo MCM. Cultural brokerage: Creating linkages between voices of lifeworld and medicine in cross-cultural clinical settings. Health (London) 2010; 14:484-504. [PMID: 20801996 DOI: 10.1177/1363459309360795] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Culturally competent healthcare has emerged as a policy solution to racial and ethnic health disparities in the United States. Current research indicates that patient-centered care is a central component of culturally competent healthcare, and a rich literature exists on how to elicit patients' lifeworld voices through open-ended questions, sensitive communication skills, and power-sharing interaction styles. But it remains largely unclear how doctors create linkages between cultures of medicine and lifeworld as two sets of incongruent meaning systems. Without such linkages, a doctor lacks the cultural tool to incorporate her patient's assumptions or frameworks into the voice of medicine, rendering it difficult to (at least partially) expand and transform the latter from within. This study explores how doctors perform this bridging work, conceptualized as cultural brokerage, on the job. Cultural brokerage entails mutual inclusion of different sets of schemas or frameworks with which people organize their meanings and information. Based on 24 in-depth interviews with primary care physicians in Northern California, this study inductively documents four empirical mechanisms of cultural brokerage: 'translating between health systems', 'bridging divergent images of medicine', 'establishing long-term relationships', and 'working with patients' relational networks'. Furthermore, the study argues that cultural brokerage must be understood as concrete 'cultural labor', which involves specific tasks and requires time and resources. I argue that the performance of cultural brokerage work is embedded in the institutional contexts of the clinic and therefore faces two macro-level constraints: the cultural ideology and the political economy of the American healthcare system.
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Whitley R. Mastery of mothering skills and satisfaction with associated health services: an ethnocultural comparison. Cult Med Psychiatry 2009; 33:343-65. [PMID: 19507013 DOI: 10.1007/s11013-009-9140-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In this paper, I examine the mastery of mothering skills and satisfaction with associated health services in women who had recently given birth in Montreal (n = 33). I compare experience between women of two distinct ethnocultural groups: Anglophone Euro-Canadian and Anglophone Afro-Caribbean. The overall aim is to discern differentials in the mastery of mothering skills and associated satisfaction with maternal and child health services. The study is framed by neo-Weberian social theory suggesting that modernization and bureaucratization increasingly eviscerate everyday skills and knowledge. These processes also lead to changes regarding what is considered credible 'authoritative knowledge.' I found that older Anglophone Euro-Canadians expressed the greatest skill deficits. They attempted to redress these deficits through consultation of professionally authored books, medical Web sites and health professionals. Older Anglophone Euro-Canadians saw these resources as sources of 'authoritative knowledge.' They also expressed dissatisfaction with related health services. In contrast, Anglophone Afro-Caribbeans and younger lower-income Anglophone Euro-Canadians expressed satisfaction with their skills. This derived from widespread previous experience with children and more extensive and readily available kith and kin networks. These were considered sources of 'authoritative knowledge' in this group. This group expressed less dissatisfaction with health services, as they did not need, or expect, these services to redress skill deficits.
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Affiliation(s)
- Rob Whitley
- Dartmouth Psychiatric Research Center, 2 Whipple Place, Suite 202, Lebanon, NH 03766, USA.
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Liamputtong P, Watson LF. The Meanings and Experiences of Cesarean Birth Among Cambodian, Lao and Vietnamese Immigrant Women in Australia. Women Health 2008; 43:63-82. [PMID: 17194678 DOI: 10.1300/j013v43n03_04] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We examined the experience of cesarean birth among 67 Cambodian, Lao and Vietnamese women who are now living in Melbourne, Australia, based on a larger ethnographic research project on childbearing, childrearing and motherhood among Southeast Asian women in Australia. We found a range of responses in the discourses of the women: some women preferred cesarean birth, but others resisted it. Women's social construction of their feelings stemmed from three interpretive frameworks: trust in medical knowledge, expectations (personal ideology of reproduction and motherhood) and communication with an understanding of their caregivers' preferences (as opposed to choice). Our findings have ramifications for health care providers working in multicultural settings. An effective dialogue between women and their health caregivers is required to keep the cesarean section rates down. In the case of immigrant women in a multicultural society like Australia, it is not the passive receipt of information but a two-way communication with adequate interpreter support that will lead to informed choice, fewer cesarean births, more satisfaction and less regret.
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Blaaka G, Schauer Eri T. Doing midwifery between different belief systems. Midwifery 2008; 24:344-52. [PMID: 17316937 DOI: 10.1016/j.midw.2006.10.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2006] [Revised: 09/26/2006] [Accepted: 10/22/2006] [Indexed: 10/23/2022]
Abstract
Childbirth has been increasingly concentrated in large centralised hospitals, with a parallel trend toward more birth interventions in Norway. These changes have resulted in new ways of framing birth from: a normal woman's life experience to a medical event. Caring for the birthing mother in a modern centralised ward, take place between two different belief- systems: a biomedical and a phenomenological. A phenomenological account of seven midwives' descriptions of skilled midwifery in a Norwegian high-technology labour ward was carried out. The focus was on how skilled midwives experience their daily work between a biomedical and a phenomenological belief system. Three themes were identified: (1) sensing where the woman is in labour, (2) being available for but not overbearing to the women and (3) being in a room of struggle. The findings are discussed from the perspective of being between these two belief-systems, with special focus on wise midwifery judgement as a way of managing the struggle.
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Affiliation(s)
- Gunnhild Blaaka
- Department of Clinical Medicine, Section of Obstetrics and Gynecology, Bergen University, Norway.
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Lo MCM, Stacey CL. Beyond cultural competency: Bourdieu, patients and clinical encounters. SOCIOLOGY OF HEALTH & ILLNESS 2008; 30:741-755. [PMID: 18444951 DOI: 10.1111/j.1467-9566.2008.01091.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In response to widely documented racial and ethnic disparities in health, clinicians and public health advocates have taken great strides to implement 'culturally competent' care. While laudable, this important policy and intellectual endeavour has suffered from a lack of conceptual clarity and rigour. This paper develops a more careful conceptual model for understanding the role of culture in the clinical encounter, paying particular attention to the relationship between culture, contexts and social structures. Linking Bourdieu's (1977) notion of 'habitus' and William Sewell's (1992) axioms of multiple and intersecting structures, we theorise patient culture in terms of 'hybrid habitus'. This conceptualisation of patient culture highlights three analytical dimensions: the multiplicity of schemas and resources available to patients, their specific patterns of integration and application in specific contexts, and the constitutive role of clinical encounters. The paper concludes with a discussion of directions for future research as well as reforms of cultural competency training courses.
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Affiliation(s)
- Ming-Cheng M Lo
- Department of Sociology, University of California, Davis, CA 95616, USA.
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Lee ASM, Kirkman M. Disciplinary discourses: rates of cesarean section explained by medicine, midwifery, and feminism. Health Care Women Int 2008; 29:448-67. [PMID: 18437594 DOI: 10.1080/07399330801949574] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In the context of international concern about increasing rates of cesarean sections, we used discourse analysis to examine explanations arising from feminism and the disciplines of medicine and midwifery, and found that each was positioned differently in relation to the rising rates. Medical discourses asserted that doctors are authorities on birth and that, although cesareans are sometimes medically necessary, women recklessly choose unnecessary cesareans against medical advice. Midwifery discourses portrayed medicine as paternalistic toward both women and midwifery, and feminist discourses situated birth and women's bodies in the context of a patriarchally structured society. The findings illustrate the complex ways in which this intervention in birth is discursively constructed, and demonstrate its significance as a site of disciplinary conflict.
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Affiliation(s)
- Amy Su May Lee
- Key Centre for Women's Health in Society, The University of Melbourne, Melbourne, Australia
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Lewando Hundt G, Sandall J, Spencer K, Heyman B, Williams C, Grellier R, Pitson L, Tsouroufli M. Experiences of first trimester antenatal screening in a one-stop clinic. ACTA ACUST UNITED AC 2008. [DOI: 10.12968/bjom.2008.16.3.28690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - J Sandall
- Midwifery & Women's Health, King's College, London
| | - K Spencer
- Reproductive Biochemistry and Director of department of Clinical Biochemistry, King George Hospital
| | - B Heyman
- Health Research, City University
| | - C Williams
- Social Science of Biomedicine, King's College London
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