Theory analysis of social justice in nursing: Applications to obstetric violence research

Abstract

The dual purpose of this article is to present a formal theory analysis combined with recommendations for the use of social justice in nursing as a framework for the study of obstetric violence in US hospitals. A theory analysis of emancipatory nursing praxis as a middle-range theory of social justice in nursing was conducted using the strategy by Walker and Avant. The theory of social justice in nursing was determined to be logical, useful, and generalizable. The soundness and usability of the theory support the recommendations made for it to be applied to the study of obstetric violence, plus quality and outcome problems in maternity care that have been resistant to sustained progress and may benefit from a new paradigm for continued study. The alignment for obstetric violence to be studied with a social justice framework is linked to the theory’s origins in critical social theory and the evolving concept of obstetric violence as a sex-specific form of violence against women that is a violation of human rights. The postmodern expansion of the body of work based on critical theory provides examples from emancipatory and feminist researchers for recognizing how the study of obstetric violence is compatible with a theoretical framework for social justice in nursing. The suitability of this framework to guide the further research needed to better understand, identify, and minimize harms from the occurrence of obstetric violence is argued. In addition, “The Code” for the American Nurses Association (ANA) is cited as a professional reference that outlines nurses’ responsibilities for practice based on ethics, human rights, and social justice that are antithetical to the occurrence of obstetric violence.

Theory analysis and evaluation of emancipatory nursing praxis: A theory of social justice in nursing

“…In 2021, Garcia completed a theoretical analysis of ENP to determine generalizability to obstetric violence. The author found ENP to be testable and generalizable to liberate nurses in obstetrics practice and become social justice allies for oppressed mothers enduring discrimination during pregnancy or birth (Garcia, 2021). However, the purpose of ENP was not to emancipate the nurse.…”

“…Its intent emphasized a learning process for nursing education to develop nursing students into social justice allies. The author provides an excellent analysis of ENP; however, the logical flow of the application of ENP to obstetric violence was not clear (Garcia, 2021) and failed to include the concepts of ENP.…”

Nursing, Social Justice, and Health Inequities

“…The theory of ENP has also influenced the creation of a middle-range theory in forensic nursing35 and in a concept analysis of nursing activism 36. To date, there has only been one other analysis on the theory of ENP 37…”

“…36 To date, there has only been one other analysis on the theory of ENP. 37 While other disciplines define social justice as a just distribution of benefits and burdens in society, this definition does not reflect social justice within a nursing context. 28,29 As Thurman and Pfitzinger-Pippe explain, it is not within nursing's mandate "to decide what is equitable or fair in terms of the distribution of health care resources."…”

Obstetric violence in the United States and other high-income countries: an integrative review

“… 10–15 Some of the power imbalances that converge during hospital-based maternity care have been discussed as coming from expected compliance with health facility policies, women being in the biomedical role of the submissive patient, and compounded vulnerabilities for marginalised groups. 3 , 7 , 16 , 17 …”