What is it about?
This paper presents a case study on the organisation of maternity healthcare in Switzerland, which has a costly healthcare system with high intervention rates within an obstetric-led maternity care model. Evidence has shown that midwifery care is associated with lower cost, higher satisfaction rates amongst women and less intervention. However, in the current model, midwives are both marginalised and underutilised. The paper focusses on the distribution of power and knowledge between midwives, women and the medical model. The varying power structures that shape the maternity care system in Switzerland are examined, using a case study approach that draws on Foucault’s concepts of the gaze, surveillance, disciplinary power, and the docile body. This paper will critically analyses the model of maternity care received by women in Switzerland and how it negatively impacts on both women’s personal and midwives’ professional autonomy whilst simultaneously driving up costs. A better understanding of the underlying power structures operating within the maternity care system may facilitate the implementation of more midwifery led care currently being endorsed by the Swiss Midwifery Association and some government agencies. This could result in reduced cost and lower intervention rates.
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Why is it important?
The paper adds a more sociological theoretical perspective as it critically analyses the model of maternity care in Switzerland
Perspectives
Switzerland has adopted a medical model of pregnancy and childbirth. I have written sociological papers in the medical/social model of childbirth and pregnancy (van Teijlingen (2014) as well as a paper applying this theoretical perspective the UK midwifery, linking it to medical control over and monitoring of pregnant women and women in childbirth (MacKenzie-Bryers & van Teijlingen, 2010; Ireland & van Teijlingen, 2013). Ireland J, van Teijlingen ER. Normal birth: social-medical model. The Practising Midwife 2013;16(11):17- 20. MacKenzie Bryers H, van Teijlingen E. (2010) Risk, Theory, Social & Medical Models: critical analysis of the concept of risk in maternity care. Midwifery, 26(5), 488-496. van Teijlingen E. (2004) A Critical Analysis of the Medical Model as used in the Study of Pregnancy and Childbirth. Sociological Research Online. 10, (2), 1-15.
Prof. Edwin R van Teijlingen
Bournemouth University
Read the Original
This page is a summary of: Women, Midwives, and a Medical Model of Maternity Care in Switzerland, International Journal of Childbirth, January 2017, Springer Publishing Company,
DOI: 10.1891/2156-5287.7.3.117.
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