‘It's your body, but…’ Mixed messages in childbirth education: Findings from a hospital ethnography
Autor: | Elizabeth Newnham, Jan Pincombe, Lois McKellar |
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Přispěvatelé: | Newnham, Elizabeth, McKellar, Lois, Pincombe, Jan |
Rok vydání: | 2017 |
Předmět: |
Adult
Nurse Midwives Decision Making Organizational culture 03 medical and health sciences 0302 clinical medicine Prenatal Education Nursing Pregnancy Informed consent Maternity and Midwifery Health care Ethnography Humans Medicine Childbirth 030212 general & internal medicine Full disclosure Anthropology Cultural Qualitative Research midwifery 030219 obstetrics & reproductive medicine business.industry informed consent Australia Obstetrics and Gynecology epidural analgesia Bioethics Organizational Culture Analgesia Epidural Personal Autonomy water immersion Female antenatal education business bioethics Qualitative research |
Zdroj: | Midwifery. 55:53-59 |
ISSN: | 0266-6138 |
DOI: | 10.1016/j.midw.2017.09.003 |
Popis: | Objective to investigate the personal, social, cultural and institutional influences on women making decisions about using epidural analgesia in labour. In this article we discuss the findings that describe practices around the gaining of consent for an epidural in labour, which we juxtapose with similar processes relating to use of water for labour and/or birth. Design ethnography. Setting tertiary hospital in Australian city. Participants sequential interviews were conducted with 16 women; hospital staff (primarily midwives and doctors) participated during six months of participatory observation fieldwork. Findings women were not given full disclosure of either practice and midwives tailored the information they gave according to the institutional policies rather than evidence. Key conclusions informed consent is an oft-cited human right in health care, yet in maternity care the micro-politics of how informed consent is gained is difficult to ascertain, leading to a situation whereby the concept of informed consent is more robust than the reality of practice; an illusion of informed consent exists, yet information is often biased towards medicalised birth practices. Implications for practice as primary maternity care-givers, midwives have a role in providing unbiased information to women; however it appears that hospital culture and policy affect the way that this information is presented. It is arguable whether women in such instances are giving true informed consent, and for this reason, the ethics of these hidden practices are questioned. |
Databáze: | OpenAIRE |
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