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Paradox of the institution: findings from a hospital labour ward ethnography

BACKGROUND: Interest in the influence of culture on birth practices is on the rise, and with it comes a sense of urgency to implement practices that aid the normalisation and humanisation of birth. This groundswell is occurring despite a broader cultural milieu of escalating technology-use and medic...

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Autores principales: Newnham, Elizabeth C, McKellar, Lois V, Pincombe, Jan I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209940/
https://www.ncbi.nlm.nih.gov/pubmed/28049522
http://dx.doi.org/10.1186/s12884-016-1193-4
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author Newnham, Elizabeth C
McKellar, Lois V
Pincombe, Jan I
author_facet Newnham, Elizabeth C
McKellar, Lois V
Pincombe, Jan I
author_sort Newnham, Elizabeth C
collection PubMed
description BACKGROUND: Interest in the influence of culture on birth practices is on the rise, and with it comes a sense of urgency to implement practices that aid the normalisation and humanisation of birth. This groundswell is occurring despite a broader cultural milieu of escalating technology-use and medicalisation of birth across the globe. Against this background, rates of epidural analgesia use by women in labour are increasing, despite the risk of side effects. Socio-cultural norms and beliefs are likely to influence pain relief choices but there is currently scant research on this topic. METHODS: This study was undertaken to gain insight into the personal, social, cultural and institutional influences on women in deciding whether or not to use epidural analgesia in labour. The study had an ethnographic approach within a theoretical framework of Critical Medical Anthropology (CMA), Foucauldian and feminist theory. Given the nature of ethnographic research, it was assumed that using the subject of epidural analgesia to gain insight into Western birth practices could illuminate broader cultural ideals and that the epidural itself may not remain the focus of the research. RESULTS: Findings from the study showed how institutional surveillance, symbolised by the Journey Board led to an institutional momentum that in its attempt to keep women safe actually introduced new areas of risk, a situation which we named the Paradox of the institution. CONCLUSIONS: These findings, showing a risk/safety paradox at the centre of institutionalised birth, add a qualitative dimension to the growing number of quantitative studies asserting that acute medical settings can be detrimental to normal birth practices and outcomes.
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spelling pubmed-52099402017-01-04 Paradox of the institution: findings from a hospital labour ward ethnography Newnham, Elizabeth C McKellar, Lois V Pincombe, Jan I BMC Pregnancy Childbirth Research Article BACKGROUND: Interest in the influence of culture on birth practices is on the rise, and with it comes a sense of urgency to implement practices that aid the normalisation and humanisation of birth. This groundswell is occurring despite a broader cultural milieu of escalating technology-use and medicalisation of birth across the globe. Against this background, rates of epidural analgesia use by women in labour are increasing, despite the risk of side effects. Socio-cultural norms and beliefs are likely to influence pain relief choices but there is currently scant research on this topic. METHODS: This study was undertaken to gain insight into the personal, social, cultural and institutional influences on women in deciding whether or not to use epidural analgesia in labour. The study had an ethnographic approach within a theoretical framework of Critical Medical Anthropology (CMA), Foucauldian and feminist theory. Given the nature of ethnographic research, it was assumed that using the subject of epidural analgesia to gain insight into Western birth practices could illuminate broader cultural ideals and that the epidural itself may not remain the focus of the research. RESULTS: Findings from the study showed how institutional surveillance, symbolised by the Journey Board led to an institutional momentum that in its attempt to keep women safe actually introduced new areas of risk, a situation which we named the Paradox of the institution. CONCLUSIONS: These findings, showing a risk/safety paradox at the centre of institutionalised birth, add a qualitative dimension to the growing number of quantitative studies asserting that acute medical settings can be detrimental to normal birth practices and outcomes. BioMed Central 2017-01-03 /pmc/articles/PMC5209940/ /pubmed/28049522 http://dx.doi.org/10.1186/s12884-016-1193-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Newnham, Elizabeth C
McKellar, Lois V
Pincombe, Jan I
Paradox of the institution: findings from a hospital labour ward ethnography
title Paradox of the institution: findings from a hospital labour ward ethnography
title_full Paradox of the institution: findings from a hospital labour ward ethnography
title_fullStr Paradox of the institution: findings from a hospital labour ward ethnography
title_full_unstemmed Paradox of the institution: findings from a hospital labour ward ethnography
title_short Paradox of the institution: findings from a hospital labour ward ethnography
title_sort paradox of the institution: findings from a hospital labour ward ethnography
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209940/
https://www.ncbi.nlm.nih.gov/pubmed/28049522
http://dx.doi.org/10.1186/s12884-016-1193-4
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