What is the value of applying social theory to maternity care?

Abstract

Pregnancy, birth and transition to motherhood are physiological processes, but they are always socially and culturally shaped and managed, forming a major event in the lives of individual women, families and communities. Childbirth is not only about individual reproduction-having a child, becoming a mother-but about social reproduction-the way in which her society and culture is reproduced. As a result, and because humans are essentially social beings, childbirth is always socially and culturally shaped and managed. In a parallel way, the roles and professional status of midwives, obstetricians and nurses are shaped by the social and cultural contexts in which they work to support women in pregnancy, birth and the transition to parenthood. Giving birth is a process which creates new social persons and roles: the foetus becomes a social person and the woman giving birth becomes a mother, her partner a father and new families are formed. As a consequence, the ways in which women give birth are a matter of very wide interest-an object of policy and a subject of social interest and concern. The ways in which childbirth is shaped and managed by legal and government frameworks, by policies, by professionals and institutions is reflective of the social and cultural context, and shaped by its history. We can borrow the anthropologist Mary Douglas's concept-the body as a microcosm-to talk about how the social world is inscribed on women's bodies and about how women's bodies and reproduction represent that social world. The idea of the body as a microcosm provides a picture at the micro-level of the body of structures and relationships at the macro-level of its social context. We can talk also of how the process of birth and the ways in which it is managed is not only influenced by the social world but also, in turn, helps to shape the social world of which it is a part. I hope by this introduction to have shown why social theory should be useful in thinking about childbirth and maternity care. I now want to suggest some ways in which social theory can form an important tool for critical thinking and analysis, which helps nurses and midwives to foster the skills and knowledge to develop, interpret, question, debate and apply evidence in practice. At the level of public health (at the macro-level of analysis), social theory helps to analyse and explain the social determinants of health and the complexity of the ways in which socioeconomic conditions, life chances, access to knowledge and power can shape health status and wellbeing. Maternity care is central to public health as wellbeing in pregnancy and the perinatal period profoundly influences the future health of the child and even following generations as well as the health of the mother. The impact of healthcare, even maternity care, takes place at a less fundamental level. At the outset of pregnancy, the health of some women and their babies is already disadvantaged through social inequalities based on class, ethnic background and residence. Inequalities are also gend...

The advancement of a gender ethics protocol to uncover gender ethical dilemmas in midwifery: a preliminary theory model

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Invisibility of Social Vulnerability and Social Rights to a Comprehensive Health Care in Chile

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