Wednesday, April 30, 2008

Midwives' experience

I spend a lot of time reading the obstetrics and midwifery literature. One of the disturbing things I have noted is the dearth of research in midwifery. There are very few attempts to determine whether the axiomatic principles of midwifery are true and whether midwifery interventions even work. There is a pathetic lack of quantitative research (which is hard to do and requires specialized knowledge), and an overabundance of qualititative "research" (which is easy to do and requires no specialize knowledge). Indeed, quantitative "research" in midwifery appears to be nothing more than collecting stories and analyzing them for patterns without even bothering to determine if the subjects are representative of women in general. Perhaps most remarkable, though, is the focus on midwives themselves. Based on the midwifery literature, it is reasonable to conclude that midwives view themselves and their experiences as a central focus of midwifery.

A cursory search of the literature reveals papers such as these:

Midwives'experience of the encounter with women and their pain during childbirth
Midwives'experience of organisational and professional change
Midwives' Experience of the Encounter with Birthing Women
Midwives'support needs as childbirth changes
The culture of midwifery in the National Health Service in England
Emotion work in midwifery: a review of current knowledge
Midwives' experience of stress on the labour ward

There is very little similar research in medicine or even in nursing. Moreover, the few papers that do exist represent a much smaller fraction of the dramatically larger medical and nursing literature. What does it mean when midwives spends such a large amount of energy and resources on studying themselves, their feelings and their experiences of patient interactions? Should healthcare providers be so concerned with what they are getting from the relationship with patients as opposed to what patients are getting from them?

0 Old Comments: