Discursive practices about the decisionmaking power of women in childbirth

Abstract

This article analyzed the decision-making power of women in childbirth expressed in the discursive practices of nurses and resident physicians in the area of obstetrics. Qualitative study with 22 residents of a maternity hospital. Data were collected through interviews and submitted to discourse analysis following Michel Foucault’s views. The discursive practices focus on risk control and normalization of the cooperative behavior of the parturient woman, culminating in restrictions on the decision-making power of women. They also value the humanization of childbirth, through the protagonism and co-responsibility of women, stressing the medical knowledge-power. It was evident an anchor in medicalization, reproduced by midwifery teaching, and in the neoliberal logic, associating women’s self-government to consumption. Autonomy and health as rights need to be strengthened by the social actors of midwifery teaching and assistance.

Immediate Puerperium During the Pandemic: Women’s Oral History in the Light of Obstetric Care Models

“…In other experiences, non-listening occurred in the disrespect for women's autonomy in LB and childbirth, and related to their desires, with a denotion of passivity due to medical attitude 19 . Professionals expect parturient behavior of obedience, passivity, docility so that they observe the instructions given, submitting the woman to the authority of technical knowledge 25 .…”

“…Women develop passive behavior, as they are more affected by social characteristics that create power structures, generating asymmetry between individuals 25 . Gender norms shape behavior, attributes and social roles that restrict female autonomy and support 25 , which may reflect on decisions about pregnancy, childbirth and the puerperium.…”

“…Women develop passive behavior, as they are more affected by social characteristics that create power structures, generating asymmetry between individuals 25 . Gender norms shape behavior, attributes and social roles that restrict female autonomy and support 25 , which may reflect on decisions about pregnancy, childbirth and the puerperium. They can strengthen the technocratic aspect of segregating women into components and the parturition experience of the flow of life, freeing professionals from the responsibility of caring for the mind and spirit of women and keeping them away from them, as they understand there is no need for involvement 8 .…”

“…In this sense, in health practices, power relations obstruct the role of women in childbirth, reaffirm the oppression of the female body and naturalize inappropriate practices 24 . The positive experience of childbirth is provided when women take the center of care and participate in care decisions with qualified and empathetic professionals in a safe environment, with the educational role of health professionals focused on informed choice and decision-making being fruitful 25 .…”

“…This weakens women's confidence and ability to choose and experience her process. For women to exercise autonomy, an environment free of violence is needed, with the guarantee of human rights and access to what is necessary to promote gender equality 25 .…”