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

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.

Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review

“…there are concerns that the medical management of pregnancy has become too intrusive and that the benefits of close surveillance and early intervention, particularly in labour, do not justify the associated cost and the loss of autonomy for women [4][5][6] . Against this background it is surprising that dietary change and weight management is not a fixed feature of pregnancy care.…”

“…Of course, this is not true of countries in the Global South where pregnancy and childbirth‐related complications remain the major cause of death for young women. Where women benefit from advances in obstetric care, there are concerns that the medical management of pregnancy has become too intrusive and that the benefits of close surveillance and early intervention, particularly in labour, do not justify the associated cost and the loss of autonomy for women 4–6 . Against this background, it is surprising that dietary change and weight management is not a fixed feature of pregnancy care.…”

“…Where women benefit from advances in obstetric care, there are concerns that the medical management of pregnancy has become too intrusive and that the benefits of close surveillance and early intervention, particularly in labour, do not justify the associated cost and the loss of autonomy for women. [4][5][6] Against this background, it is surprising that dietary change and weight management is not a fixed feature of pregnancy care. Dietary advice is loose and in addition to being given a list of things to avoid (potential sources of food pathogens, liver, oily fish, alcohol and caffeine) women are merely advised to consume a healthy 'balanced' diet.…”