Has the medicalisation of childbirth gone too far?

Johanson, Richard; Newburn, Mary; Macfarlane, Alison

doi:10.1136/bmj.324.7342.892

Cited by 361 publications

(226 citation statements)

References 20 publications

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“…These impressions coincide with the results reported by other authors (Johnson et al, 1992;Williams, 2006). The possibility of controlling pain by applying epidural anaesthetic is an important source of reassurance for mothers-to-be; epidural anaesthetic is widely used in Spain as the method of choice for pain relief during childbirth (Johanson et al, 2002;Sabaté et al, 2006). The literature notes that the perception of what constitutes normal maternity care depends too on the messages the women have received from their family and friends, (Maroto-Navarro, 2004;Young, 2009) and the social imaginary in Spanish considers pain relief via spinal techniques as a clear sign of quality of care.…”

Section: Discussionsupporting

confidence: 85%

Satisfaction with pregnancy and birth services: The quality of maternity care services as experienced by women

et al. 2011

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Section: Discussionsupporting

confidence: 85%

Satisfaction with pregnancy and birth services: The quality of maternity care services as experienced by women

et al. 2011

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“…While this may be part due to the absence of specialist services, this philosophy of care may also be indicative of the growing medicalisation of the perinatal period (Johanson et al, 2002, Parry, 2006, Benoit et al, 2010, Christiaens et al, 2013 and the ensuing perception of woman as physical vessels for the foetus, devoid of emotional and cognitive needs (Annas, 1986, Wetterberg, 2004, Ogle et al, 2011, Meurk et al, 2014 Some research suggests that women may be reluctant to disclose mental health problems for fear of stigma and loss of custody (Boots Family Trust, 2013), but this was not the case for all of the women in this study, with some, like the women in Darwin et al's (2015) study, volunteering their mental health history to the midwife during their booking encounters.…”

Section: Discussionmentioning

confidence: 99%

Mothers with mental health problems: Contrasting experiences of support within maternity services in the Republic of Ireland

et al. 2016

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Objective: to explore the views and experiences of women with mental health difficulties, in the Republic of Ireland, accessing and receiving care from publicly-funded maternity care services during pregnancy, childbirth and immediate postnatal period in hospital.Participants: In total 20 women with a range of mental health problems were recruited. The women had given birth within maternity services with and without specialist perinatal mental health services.Design: A qualitative descriptive design using in-depth face to face interviews was used to explore women's experience. Data were analysed using an inductive thematic process.Findings: the study offers valuable insights into the maternity care experiences of women with mental health problems, and highlights the deficits and fragmentation of care in maternity units that do not have a specialist mental health service. Even when the women voluntarily disclosed their difficulties, midwives appeared to lack the knowledge and skills to respond sensitively and responsively.Key conclusions and implications for practice: there is a need to expand perinatal mental health services in the Republic of Ireland, so that quality service provision is not dependent on geography. In addition, there is a need for education to address the lack of knowledge and understanding of perinatal mental health problems amongst maternity care practitioners.

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“…In Western countries, childbirth is increasingly managed as a medical problem: women no longer give birth, but are delivered; fetuses are monitored and screened; labor can be artificially induced or stopped, and effective pain relief is widely used. Women's expectations might reflect this process of increasing medicalization of childbirth (Johanson, Newburn, & Macfarlane, 2002). How, then, is the occurrence of fear of childbirth explained in contexts in which medical assistance is readily available?…”

Section: Introductionmentioning

confidence: 99%

Pregnant Women's Fear of Childbirth in Midwife- and Obstetrician-Led Care in Belgium and the Netherlands: Test of the Medicalization Hypothesis

2011

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Fear of childbirth has gained importance in the context of increasing medicalization of childbirth.Belgian and the Dutch societies are very similar but differ with regard to the organization of maternity care. The Dutch have a high percentage of home births and low medical intervention rates.In contrast, home births in Belgium are rarer, and the medical model is more widely used. By comparing the Belgian and the Dutch maternity care models we explored the association between fear of childbirth and medicalization.An antenatal questionnaire was completed by 833 women at 30 weeks of pregnancy. Fear of childbirth was measured by a shortened Dutch version of the Childbirth AttitudesQuestionnaire. A four-dimensional model with baby-related, pain and injuries-related, general and personal control-related, and medical interventions and hospital care-related fear, fitted well in both countries. Multiple regression analysis showed no country differences, except that Belgian women in midwife-led care were more fearful of medical interventions and hospital care than the Dutch. For the other dimensions, both Belgian and Dutch women receiving midwifery care reported less fear compared to those in obstetric antenatal care. Hence, irrespective of the maternity care model, antenatal care providers are crucial in preventing fear of childbirth.

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Has the medicalisation of childbirth gone too far?

Cited by 361 publications

References 20 publications

Satisfaction with pregnancy and birth services: The quality of maternity care services as experienced by women

Satisfaction with pregnancy and birth services: The quality of maternity care services as experienced by women

Mothers with mental health problems: Contrasting experiences of support within maternity services in the Republic of Ireland

Pregnant Women's Fear of Childbirth in Midwife- and Obstetrician-Led Care in Belgium and the Netherlands: Test of the Medicalization Hypothesis

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