Towards a social model of childbirth: part one

Abstract

Though critiques of the biomedical model of childbirth have served to highlight the shortcoming of present-day maternity services, writing on an alternative social model is less developed. Specifically, contrasting beliefs within each model and how that is applied requires more reflection. These two articles suggests how the social model of birth may be understood, both as beliefs and values and as an applied midwifery model. Part one examines contrasting emphases between a medical and social model in relation to their beliefs and values around childbirth, the roles of woman users, obstetricians and midwives.

Women׳s views on partnership working with midwives during pregnancy and childbirth

“…Foucault (1977) argued that power relations function through medical surveillance, presented as expert knowledge, which when internalised by the patients and other health care professionals, resulted in acceptance of the medical position, however this position can be resisted if the subordinate individual or group are empowered. Walsh et al (2002) further contended that as long as midwives continue to be employed by the NHS, and are based in Consultant units, where birth continues to be managed using an obstetric model, change will continue to be slow. They argued that if midwives were all community based and more closely aligned with women and social care workers, the social model of care would be enabled to flourish (Walsh et al, 2002).…”

“…Walsh et al (2002) further contended that as long as midwives continue to be employed by the NHS, and are based in Consultant units, where birth continues to be managed using an obstetric model, change will continue to be slow. They argued that if midwives were all community based and more closely aligned with women and social care workers, the social model of care would be enabled to flourish (Walsh et al, 2002). Moreover, Fisher et al (2006) found that women experienced childbirth fear at both a personal and social level, which was exacerbated by the medicalised environment that birth takes place in.…”

“…2009). It has been argued that without a strategic plan to decentralise maternity care from obstetric units to birth centres, and a re-balancing of the social-medical continuum, attempts to provide a social model will fail (Johansen et al, 2002;Walsh et al, 2002;Bryers et al, 2010).…”

“…Midwives who adopt an holistic social model of care accept risk, respect the natural process and act as a supportive partner, guiding women as they journey through childbirth without the constraint of time (Walsh et al, 2002;Bryers et al, 2010). However, some midwives practice in a highly medicalised way, utilising all available technology to support birth, under the direction of obstetricians.…”

“…Choice of place of birth is a particularly contentious area historically, with proponents of the medical model arguing that birth is only normal in retrospect, whereas supporters of the midwifery/social model of care have argued that birth is a natural process and that women should be empowered to follow their instincts and let go, to facilitate a safe and satisfying birth experience (Walsh et al, 2002;Bryers, 2010). Women in this study were not offered the full range of birth options, despite the fact that within both NHS Trusts all of the options were available.…”