UVM Theses and Dissertations
Format:
Print
Author:
Waters, Tanya K. D.
Dept./Program:
Nursing
Year:
2004
Degree:
M.S.
Abstract:
Certified Nurse-Midwives (CNMs) practice in a woman-centered model of care, in contrast to the dominant biomedical model of care characterized by authoritative knowledge and the belief in the value of science and technology over nature. The clinical value of the woman-centered model of care during pregnancy and childbirth has been demonstrated in numerous studies while the impact of CNM care on sociological outcomes such as social change has yet to be fully investigated. This phenomenological study explored the perceptions and lived experiences of Certified Nurse-Midwives as they participate in social change through their professional relationships with women. Study participants identified the two models guiding care of pregnant and birthing women in the United States. In the biomedical model, a physician is the expert in the pregnancy and birthing experience. The woman-centered model of care that is the basis for CNM care, provides women with the message that they are trusted, capable, competent experts in the pregnant and birthing experience.
Marx's dialectical theory was used as a way of understanding social change. Change, according to Marx, occurs as the result of socially generated internal contradictions that create tension toward some form of resolution. Participants in this study identified that tension between the two models of care does exist in the pregnancy and birthing experiences of women they have worked with. Participants also identified that women resolve this tension by redefinition of self identity to incorporate new knowledge and experiences gained through the pregnancy and birthing experience with CNM care. Most commonly, women incorporated feelings of personal power and the belief that they were worthy of making informed decisions in other areas of their lives. Participants identified social change resulting from the redefinition of self identity including changes in relationships with partners, children and families, seeking out educational and career opportunities and social activism.
Participants in this study did not identify this process as one in which they contributed directly to social change. Rather, they identified specific aspects of CNM care that created the dialectic experience for women, but identified individual women as involved in the resolution of the tension between models and the process of social change that followed. In other words, CNMs create the potential for women to create social change through redefinition of self identity.
Marx's dialectical theory was used as a way of understanding social change. Change, according to Marx, occurs as the result of socially generated internal contradictions that create tension toward some form of resolution. Participants in this study identified that tension between the two models of care does exist in the pregnancy and birthing experiences of women they have worked with. Participants also identified that women resolve this tension by redefinition of self identity to incorporate new knowledge and experiences gained through the pregnancy and birthing experience with CNM care. Most commonly, women incorporated feelings of personal power and the belief that they were worthy of making informed decisions in other areas of their lives. Participants identified social change resulting from the redefinition of self identity including changes in relationships with partners, children and families, seeking out educational and career opportunities and social activism.
Participants in this study did not identify this process as one in which they contributed directly to social change. Rather, they identified specific aspects of CNM care that created the dialectic experience for women, but identified individual women as involved in the resolution of the tension between models and the process of social change that followed. In other words, CNMs create the potential for women to create social change through redefinition of self identity.