gms | German Medical Science

Background: Obstetrics in Germany is increasingly influenced by medicalization and mechanization. Midwives see themselves being responsible for supporting and promoting physiological processes in the context of pregnancy, birth and postnatal stage. The autonomy of women has been pointed out as a major principle in attendance of midwives [1]. However, the notion of autonomy is not clearly defined. Realizing patient’s autonomy by obtaining informed consent as it is defined in medical ethics is based on a cognitivist approach disregarding the situational dispositions as well as the social relationships of the persons involved. An embodied definition of autonomy represents a potential alternative. The concept of embodiment (Leiblichkeit) differentiates between two perspectives: on the one hand, the objectifying view of oneself and on others, and on the other hand, the experiencing of self participating in vivid practice [2]. By and through embodiment, humans are fully oriented to their environment and social world, and also influenced by these factors. Accordingly, the situation and the environment (Lebenswelt) of the decision-maker have to be considered. The quality and the conditions of contact to the other play a decisive role. Furthermore, social, political and cultural conditions that take part in decision-making are of importance. Embodiment in health care respectively midwifery care has been examined a) primarily in Anglo-American areas and specifically from a feminist point of view, b) particularly theoretically and less frequently empirically, c) if empirically, then by using interviews as an investigation method, d) not exhaustively in its ethical dimensions.

Aim: The core question of the present study is: How is the interaction between midwives and women being structured in terms of embodiment and autonomy?

Method: In order to answer the question, a qualitative-empirical approach within the methodological framework of grounded theory is employed. Data collection will be carried out with the help of participant observation, ethnographic interviewing and guided interviews. My investigation covers the whole range of clinical and extra-clinical settings of midwifery, as well as the entire pregnancy, birth and postnatal stages. The analyses will be carried out using coding procedures developed by Strauss [3] and Strauss; Corbin [4] as well as situational analysis proposed by Clarke [5].

Relevance and ethical considerations: The goal of the project is to describe the specific contact with women and families that is established by midwives. Thus, the unique contribution of midwifery to a woman-oriented and family-oriented care is emphasized. Furthermore, it is planned to design a concept for teaching reflexive bodily-embodied contact to women in midwifery education. Participants are informed about the confidential handling of data, which will be anonymized and pseudonymised. The researcher is committed to secrecy.

As it is too early to present research findings, it is intended to present a poster showing the research project as described in this abstract.