Woman-centred ethics: A feminist participatory action research

Buchanan, Kate; Geraghty, Sadie; Whitehead, Lisa; Newnham, Elizabeth

doi:10.1016/j.midw.2022.103577

Cited by 9 publications

(5 citation statements)

References 45 publications

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“…The context of pregnancy and birth carries no legal exemption [ 39 ]. Recent research identifies that in the maternity sector in particular, this does not always occur [ 29 , 30 , 40 ]. Knowledge and policy, skewed towards medicalised processes, shapes the way that choices are presented to pregnant and birthing women and people [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

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Tending to the machine: The impact of intrapartum fetal surveillance on women in Australia

Fox,

Coddington,

Levett

et al. 2024

PLoS ONE

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Qualitative research about women and birthing people’s experiences of fetal monitoring during labour and birth is scant. Labour and birth is often impacted by wearable or invasive monitoring devices, however, most published research about fetal monitoring is focused on the wellbeing of the fetus. This manuscript is derived from a larger mixed methods study, ‘WOmen’s Experiences of Monitoring Baby (The WOMB Study)’, aiming to increase understanding of the experiences of women and birthing people in Australia, of being monitored; and about the information they received about fetal monitoring devices during pregnancy. We constructed a national cross-sectional survey that was distributed via social media in May and June, 2022. Responses were received from 861 participants. As far as we are aware, this is the first survey of the experiences of women and birthing people of intrapartum fetal monitoring conducted in Australia. This paper comprises the analysis of the free text survey responses, using qualitative and inductive content analysis. Two categories were constructed, Tending to the machine, which explores participants’ perceptions of the way in which clinicians interacted with fetal monitoring technologies; and Impressions of the machine, which explores the direct impact of fetal monitoring devices upon the labour and birth experience of women and birthing people. The findings suggest that some clinicians need to reflect upon the information they provide to women and birthing people about monitoring. For example, freedom of movement is an important aspect of supporting the physiology of labour and managing pain. If freedom of movement is important, the physical restriction created by a wired cardiotocograph is inappropriate. Many participants noticed that clinicians focused their attention primarily on the technology. Prioritising the individual needs of the woman or birthing person is key to providing high quality woman-centred intrapartum care. Women should be provided with adequate information regarding the risks and benefits of different forms of fetal monitoring including how the form of monitoring might impact her labour experience.

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Section: Discussionmentioning

confidence: 99%

“…Using a care ethics lens [20,[28][29][30][31] to interpret these findings identifies an endemic lack of concern in maternity settings for genuine ethical care. Although technology can be useful in contributing to an overall clinical picture, it is not a replacement for attentive, human caring.…”

Section: Discussionmentioning

confidence: 99%

Tending to the machine: The impact of intrapartum fetal surveillance on women in Australia

Fox,

Coddington,

Levett

et al. 2024

PLoS ONE

Self Cite

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“…To do justice to the complexity and multidimensionality of the birth integrity framework in methodological terms, mixed-methods appear to be an appropriate approach, allowing a combination of positivistic and interpretivist concepts as well as triangulation of quantitative and qualitative data [ 132 ]. One way to prioritize feminist ethics at all stages of research is to adopt a participatory action approach [ 133 ].…”

Section: Discussionmentioning

confidence: 99%

A critical review: developing a birth integrity framework for epidemiological studies through meta-ethnography

Batram-Zantvoort,

Wandschneider,

Razum

et al. 2023

BMC Women's Health

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Over the past decade, there has been growing evidence that women worldwide experience sub-standard care during facility-based childbirth. With this critical review, we synthesize concepts and measurement approaches used to assess maternity care conditions and provision, birth experiences and perceptions in epidemiological, quantitative research studies (e.g., obstetric violence, maternal satisfaction, disrespect or mistreatment during childbirth, person-centered care), aiming to propose an umbrella concept and framework under which the existing and future research strands can be situated. On the 82 studies included, we conduct a meta-ethnography (ME) using reciprocal translation, in-line argumentation, and higher-level synthesis to propose the birth integrity multilevel framework. We perform ME steps for the conceptual level and the measurement level. At the conceptual level, we organize the studies according to the similarity of approaches into clusters and derive key concepts (definitions). Then, we ‘translate’ the clusters into one another by elaborating each approach’s specific angle and pointing out the affinities and differences between the clusters. Finally, we present an in-line argumentation that prepares ground for the synthesis. At the measurement level, we identify themes from items through content analysis, then organize themes into 14 categories and subthemes. Finally, we synthesize our result to the six-field, macro-to-micro level birth integrity framework that helps to analytically distinguish between the interwoven contributing factors that influence the birth situation as such and the integrity of those giving birth. The framework can guide survey development, interviews, or interventional studies.

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“…Contrary to the HCP's understanding of humanised practice in this review, the lack of time required to counsel women adequately in complex scenarios may result in reduced opportunities for negotiation and more emphasis on decision-making. Regardless of whether the woman chooses to negotiate care outside of the normal guidelines and protocols, continuity of carer for women who are high risk would support the development of a relationship which may support the counselling, negotiation and the decision-making process identified in Fig 3 . Wider literature has also previously identified the importance of building and maintaining a relationship with a known caregiver [57,59] and is now identified as a route to achieving a harmonised relationship with women and a tenet of a women centered ethics approach [60]. A recently published integrative review supports the approach of continuity of carer for all women, regardless of risk status [61].…”

Section: Discussionmentioning

confidence: 99%

Midwives’, obstetricians’, and nurses’ perspectives of humanised care during pregnancy and childbirth for women classified as high risk in high income countries: A mixed methods systematic review

Curtin,

Murphy,

Savage

et al. 2023

PLoS ONE

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Women classified as ‘high risk’ or ‘complicated’ in pregnancy and childbirth have increased difficulty in accessing humanised care/humanisation in childbirth due to perceptions that this approach rejects the use of intervention and/or technology. Humanised care recognises the psychological and physical needs of women in pregnancy and birth. A mixed methods systematic review using a convergent segregated approach was undertaken using the Joanne Briggs Institute (JBI) methodology. The objective of the review was to identify the presence of humanisation for women with high risk pregnancy and/or childbirth in high income countries. Studies were included if they measured humanisation and/or explored the perspectives of midwives, obstetricians, or nurses on humanisation for women classified as having a high-risk or complicated pregnancy or childbirth in a high income country. Qualitative data were analysed using a meta-aggregative approach and a narrative synthesis was completed for the quantitative data. All studies were assessed for their methodological quality using the MMAT tool. Four databases were searched, and nineteen studies met the inclusion criteria. A total of 1617 participants from nine countries were included. Three qualitative findings were synthesised, and a narrative synthesis of quantitative data was completed. The integration of qualitative and quantitative data identified complimentary findings on: (i) the importance of developing a harmonised relationship with women; (ii) increased time counselling women on their choices; and (iii) fear of professional reputational damage if caring outside of protocols. Negotiating with women outside of protocols may have a wider impact on the professional than first thought. Understanding how healthcare professionals individualise care for women at risk in labour requires further investigation.

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Woman-centred ethics: A feminist participatory action research

Cited by 9 publications

References 45 publications

Tending to the machine: The impact of intrapartum fetal surveillance on women in Australia

Tending to the machine: The impact of intrapartum fetal surveillance on women in Australia

A critical review: developing a birth integrity framework for epidemiological studies through meta-ethnography

Midwives’, obstetricians’, and nurses’ perspectives of humanised care during pregnancy and childbirth for women classified as high risk in high income countries: A mixed methods systematic review

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