Perspectives and experiences of healthcare professionals regarding the medicalisation of pregnancy and childbirth

Abstract

Background: Pregnancy and childbirth hold broader cultural and societal implications and entail more than simply a natural event. Today, these otherwise natural phenomena are driven by the development of surveillance medicine in a risk-averse society. This affects how both healthcare professionals and women perceive medicalisation and is influencing changes in clinical practice surrounding childbirth.

Aim: The aim of the study was to explore the phenomenon of the medicalisation of pregnancy and childbirth in Slovenia as perceived and experienced by healthcare professionals, namely midwives and obstetricians.

Methods: A descriptive phenomenological approach was used. A purposive sample included 16 midwives and 4 obstetricians working in perinatal healthcare. The data were collected using in-depth, semi-structured, one-to-one interviews and analysed using the phenomenological methodology approach proposed by Colaizzi.

Findings: The two professional groups are well aware of the medicalisation of pregnancy and childbirth, yet there are some differences in experiencing these phenomena. This is revealed with respect to three identified themes: (1) medicalisation as a social construct; (2) unrecognised importance of evidence-based practice in changing medicalised care; and (3) the dimensionalities of the Caesarean section.

Conclusion: Our study suggests woman-centred care that supports autonomy should be more strongly promoted and strategies supporting women with different childbirth preferences developed. The findings also show interprofessional collaboration should be further explored since midwives' autonomy and participatory decision-making in clinical settings is encountering some unresolved issues within the scope of midwifery practice that affect their professionalism.

Keywords: Midwives; Obstetricians; Risk; Woman-centred care; Women’s health.