‘With woman’ philosophy: examining the evidence, answering the questions

Abstract

'With woman', 'woman centred' and 'in partnership with women' are new terms associated with midwifery care in Australia, and the underlying philosophy has emerged both as an antidote to the medicalisation of pregnancy and in a bid to reacquaint women with their natural capacity to give birth successfully and without intervention. A reorientation of midwifery services in the 1990s, a shift towards midwifery-led care (MLC) and the subsequent introduction of direct entry midwifery programs all contributed to this new direction. Central concepts are a focus on the childbearing woman and a valuing of women's experiences. While this philosophical re-alignment has been applauded by many midwives in terms of maternal empowerment and improved autonomy for midwives, there are nonetheless some concerns that, with its emphasis on normality, midwifery-led care is in danger of becoming an exclusionary model. Particular concerns include meeting the needs of a growing cohort of women, those with 'high risk' pregnancies, and the educational adequacy of direct entry midwifery programs. To date, there has been no thorough evaluation of this emerging midwifery philosophy in Australia. In order to open the debate, this paper aims to initiate a discussion of 'with woman' midwifery care as it applies to Australian practice.

Parents’ experiences of midwifery students providing continuity of care

“…'With woman', 'woman centred' and 'in partnership with women' are concepts associated with good clinical results and increased maternal satisfaction. The emphasis is on the pregnant woman and what she experiences, focusing on a midwife-woman relationship characterised by trust and rapport, empowerment of the woman, and individual personalised care by the midwife (Page, 2003;Carolan and Hodnett, 2007). In many parts of the world, midwives are the primary providers of maternity care.…”

Midwifery Care: Reflections of Midwifery Clients

“…Most of the previous research on midwifery has focused on the following topics: d client care (Carolan & Hodnett, 2007;Fraser, 1999;Gilje, 1992;Green, Renfrew, & Curtis, 2000;Halldorsdottir & Karlsdottir, 1996;Kennedy, 1995Kennedy, , 2000Kennedy, Rousseau, & Low, 2003;Page, 2003;Proctor, 1998); d satisfaction (Goodman, Mackey, & Tavakoli, 2004;Hundley, Milne, Glazener, & Mollison, 1997;Knapp, 1996;Morgan, Fenwick, McKenzie, & Wolfe, 1998;Tinkler & Quinney, 1998;Waldenstrom, 1998); (Berg, Lundgren, Hermansson, & Wahlberg, 1996;Bowers, 2002;Coffman & Ray, 1999;Fleming, 1998;Hodnett, 2002;Hodnett, Gates, Hofmeyr, & Sakala, 2002;Hunter, 2002Hunter, , 2009Lavender, Walkinshaw, & Walton, 1999;Tarkka & Paunonen, 1996); and d outcomes (Gibbins & Thomson, 2001;Green, Coupland, & Kitzinger, 1990;Hardin & Buckner, 2004;Mackey, 1995;Proctor, 1998;Rooks, 1999).…”

"Not worth doing prenatal care": an ethnographic study of a low-income community

“…The elements involved in this type of proposal must be identified and designed together with the target population, which improves the respect of the perspectives of the target population. 18 However, we must consider that the majority of PCU do not provide care through FHS. Consequently, facilities that offer health care, including PNC, are very difficult to access.…”