Psychosocial Aspects of Midwifery Care
Practicing midwives in our healthcare system today need to have an understanding of political and social factors of their practice in order to provide optimum service for the women and families in their care. The psychosocial needs of the individual should be considered, and midwives should contemplate external factors that may affect the woman’s health, pregnancy, outcome and their home lives. This is why the whole picture of a woman’s life should be respected in order to gain contextual knowledge.
With the aid of a scenario true to real life practice, this essay will aim to: identify and analyse the psychosocial impact of the processes of childbirth upon women and their families; explore the social and political context of midwifery care; examine the changing role of women as a result of childbirth; discuss sociological explanations for inequalities in health and how these affect health and the provision of maternity care; discuss the impact of medicalising childbearing; explore psychological processes of those involved maternity care; explore social interaction between individuals, interpersonal skills in midwifery practice and the implications.
The chosen scenario involves Mina (Mother-to-be), Carl (Mina’s Husband), Fay (Midwife) and Inez (Student Midwife). From the very beginning, it is obvious that Carl is a very supportive husband, which has a positive affect on Mina from what can be gathered by the writing of the scenario. On the other side, with Inez and Fay, there is a feeling of negativity; Fay is very dismissive of the birth plan, and Inez’s attempt to interact with the couple using their plan through discussion “Shall I go through [the birth plan] with them when we go back to the room?”… “Won’t need that, she’ll end up with a section.”
Analysis of the scenario will begin with Carl, the supportive husband. According to FathersDirect.com (2007), fathers often feel marginalised from the pregnancy, birth experience, and many may feel unsure of their role in the new triad postpartum. Due to not experiencing any symptoms of pregnancy, men have a very indirect experience of this important time in the couple’s lives. Though there is the argument of couvade syndrome, where partners of the pregnant woman experience symptoms of pregnancy themselves, such as food cravings, bloated abdomen, fatigue and morning sickness (Brennan, 2008). Carl, however, seems to be very comfortable with his role in Mina’s period of childbearing. He has taken the role of supporter to the extent that he has adopted the title of “Team GB” for the couple. Signifying a bond between them that goes beyond husband and wife.
It is now the social trend for the partner to be present and the birth; it has been shown in research that the partner’s presence in the preparatory classes and/or in the delivery room generally results in reduced maternal and fetal distress (Stapleton, 2012). This includes a reduced need for analgesia (Raphael-Leff, 2008). How men react to impending fatherhood is determined by how they view the concept of gender identity (Rodgers, 2011). Their reaction is also influenced by how their pregnant wife/partner encourages his bonding with the fetus for the duration of the pregnancy (Combs-Orne and Renkert, 2009.).
There is a model that suggests that there are categories that each parent can fall in to regarding how they accept and behave towards childbearing and childbirth. This research does take in to consideration that not all will fit strictly in to either one category or the other, and that there are those groups in between who do not quite fit the criteria. Focussing on the model of “Facilitators” and “Regulators” in this instance explores the Mina’s maternal orientation towards her pregnancy and motherhood (Raphael-Leff, 1986). The Facilitator adapts her life around her pregnancy/child, and responds to its needs as they arise. The Regulator however...
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Raphael-Leff (2001). Pregnancy: An Inside Story. 2nd ed. London: Sheldon Press.
Raynor, M., England, C. (2010). Psychology for Midwives: Pregnancy, Childbirth and Puerperium. London: Open University Press.
Reed, R. (2012). Asynclitism: a well aligned baby or a tilted head?. Available: http://midwifethinking.com/2012/04/25/asynclitism-a-well-aligned-baby-or-a-tilted-head/. Last accessed 25th November 2012.
Rodgers, O (2011). Language, gender and power in discourses of maternity. The discursive construction of gender identity in pregnancy advice literature in English and French. University of Limerick: University of Limerick.
Stapleton. (2012). Perceived partner support in pregnancy predicts lower maternal and infant distress. Journal of Family Psychology. 26 (3).
Zeanah, C. (2009). The Pregnant Father. In: Zeanah, C Handbook of Infant Mental Health. 3rd ed. New York: The Guilford Press.
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