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Risk, Pregnancy and Childbirth最新文献

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Time, risk and midwife practice: the vaginal examination 时间、风险和助产士做法:阴道检查
Pub Date : 2018-10-11 DOI: 10.4324/9781315266077-10
Mandie Scamell a, Mary Stewart b
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引用次数: 0
Pregnancy, risk perception and use of complementary and alternative medicine 妊娠、风险认知以及补充和替代药物的使用
Pub Date : 2018-10-11 DOI: 10.4324/9781315266077-11
Mary Mitchell a, Stuart McClean b
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引用次数: 1
To what extent are women free to choose where to give birth? How discourses of risk, blame and responsibility influence birth place decisions 妇女在多大程度上可以自由选择在哪里生孩子?风险、责备和责任的话语如何影响生育地点的决定
Pub Date : 2018-10-11 DOI: 10.4324/9781315266077-7
Kirstie Coxon a, Jane Sandall a, Naomi J. Fulop b
Over the past 50 years, two things have changed for women giving birth in high- income nations; birth has become much safer, and now takes place in hospital rather than at home. The extent to which these phenomena are related is a source of ongoing debate, but concern about high intervention rates in hospitals, and financial pressures on health care systems, have led governments, clinicians and groups representing women to support a return to birth in ‘ alternative ’ settings such as midwife-led birth centres or at home, particularly for well women with healthy pregnancies. Despite this, most women still plan to give birth in high-technology hospital labour wards. In this article, we draw on a longitudinal narrative study of pregnant women at three maternity services in England between October 2009 and November 2010. Our findings indicate that for many women, hospital birth with access to medical care remained the default option. When women planned hospital birth, they often conceptualised birth as medically risky, and did not raise concerns about overuse of birth interventions; instead, these were considered an essential form of rescue from the uncertainties of birth. Those who planned birth in alternative settings also emphasised their intention, and obligation, to seek medical care if necessary. Using sociocultural theories of risk to focus our analysis, we argue that planning place of birth is mediated by cultural and historical associations between birth and safety, and further influenced by prominent contemporary narratives of risk, blame and the responsibility. We conclude that even with high-level support for ‘ alternative ’ settings for birth, these discourses constrain women ’ s decisions, and effectively limit opportunities for planning birth in settings other than hospital labour wards. Our contention is that a combination of cultural and social factors helps explain the continued high uptake of hospital obstetric unit birth, and that for this to change, birth in alternative settings would need to be positioned as a culturally normative and acceptable practice.
在过去的50年里,对于高收入国家的妇女来说,有两件事发生了变化;分娩变得更加安全,现在在医院而不是在家里进行。这些现象的关联程度一直是争论的一个来源,但对医院干预率高以及卫生保健系统面临的财政压力的担忧,已导致政府、临床医生和代表妇女的团体支持在“替代”环境(如助产士领导的分娩中心或在家)重返分娩,特别是对健康怀孕的健康妇女。尽管如此,大多数妇女仍计划在高科技医院的产房分娩。在本文中,我们对2009年10月至2010年11月期间在英国三家产科服务机构的孕妇进行了纵向叙事研究。我们的研究结果表明,对许多妇女来说,在医院分娩并获得医疗护理仍然是默认的选择。当妇女计划在医院分娩时,她们往往将分娩概念化为医学上的风险,并且没有提出对过度使用分娩干预措施的担忧;相反,这些被认为是从出生的不确定性中拯救出来的基本形式。那些计划在其他环境中生育的人也强调了他们在必要时寻求医疗护理的意图和义务。利用风险的社会文化理论,我们的分析重点是,我们认为计划出生地点是由出生和安全之间的文化和历史联系调解的,并进一步受到当代突出的风险、指责和责任叙事的影响。我们的结论是,即使对分娩的“替代”环境有高水平的支持,这些话语也限制了妇女的决定,并有效地限制了在医院产房以外的环境中计划生育的机会。我们的观点是,文化和社会因素的结合有助于解释医院产科病房分娩的持续高使用率,为了改变这种情况,在其他环境中分娩需要被定位为一种文化规范和可接受的做法。
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引用次数: 0
Fateful moments and the categorisation of risk: Midwifery practice and the ever-narrowing window of normality during childbirth 决定性时刻和风险分类:助产实践和分娩过程中不断缩小的正常窗口
Pub Date : 2018-10-11 DOI: 10.4324/9781315266077-12
Mandie Scamell a, Andy Alaszewski b
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引用次数: 1
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Risk, Pregnancy and Childbirth
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