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Title:MEDIKALIZACIJA NOSEČNOSTI IN PORODA KOT DRUŽBENA KONSTRUKCIJA
Authors:Prosen, Mirko (Author)
Tavčar Krajnc, Marina (Mentor) More about this mentor... New window
Files:.pdf DOK_Prosen_Mirko_2016.pdf (4,66 MB)
 
Language:Slovenian
Work type:Doctoral dissertation (mb31)
Typology:2.08 - Doctoral Dissertation
Organization:FF - Faculty of Arts
Abstract:Medikalizacija je sociokulturni proces, skozi katerega nemedicinski problemi postanejo opredeljeni in zdravljeni kot medicinski. To je oblika normativnega družbenega procesa, kateremu je podvrženo vse več fizioloških pojavov, med njimi tudi nosečnost in porod, ki nista le biološki, temveč tudi kulturni in družbeni dogodek. Doktorska disertacija obravnava medikalizacijo nosečnosti in poroda v širšem družbenem kontekstu oblikovanja porodnih praks. V teoretičnem delu je pojasnjen proces medikalizacije na primeru nosečnosti in poroda, ki se konča z identifikacijo indikatorjev medikalizacije poroda. Namen, v empiričnem delu zasnovane raziskave, je bil z združevanjem kvalitativnih in kvantitativnih metod, celovito proučiti fenomen medikalizacije nosečnosti in poroda. V ta namen so bila oblikovana naslednja raziskovalna vprašanja: kako doživljajo in sprejemajo medikalizacijo nosečnosti in poroda ženske po lastni izkušnji in kakšen je njihov odnos do naravnega poroda; kako zaznavajo in doživljajo medikalizacijo nosečnosti in poroda ter naravni porod zdravstveni delavci, ki sodelujejo pri zagotavljanju zdravstvenega varstva žensk; kakšna je razlika v stopnji medikalizacije poroda med Slovenijo in drugimi izbranimi državami. V sklopu kvalitativne metodologije sta bili uporabljeni narativna metoda in fenomenološka študija, medtem ko je bila v sklopu kvantitativne metodologije uporabljena metoda sekundarne analize podatkov. V stratificiran namenski vzorec narativne metode je bilo vključenih 19 porodnic in v namenski vzorec fenomenološke študije 16 babic in 4 porodničarji. Priročni vzorec držav v sklopu sekundarne analize podatkov, je poleg Slovenije vključeval tudi Norveško in Finsko. Podatki narativne metode, analizirani s pomočjo metode analize vsebine, skozi štiri osrednje teme izpostavljajo porodne prakse, prepričanja in tradicije, vpete v institucionalno rojevanje; odzive nosečnic na spremljanje in odkrivanje deviantnosti v nosečnosti; reprezentacije materinstva in avtonomijo odločanja. Iz porodnih zgodb je razvidno, da je prva porodna izkušnja za porodnice najbolj določujoča in obenem tudi najbolj učeča izkušnja. Ravnanja porodnic usmerjajo spoznana tveganja, povezana s porodom, ki jih v očeh porodnic oblikujejo zdravstveni delavci, ožja družina, socialne mreže in mediji. Izsledke fenomenološke analize po Colaizzi, ki je bila narejena posebej za babice in porodničarje, pri babicah opredeljuje 12 tematskih skupin in porodničarjih 11. Oboji se zavedajo, da je porod naravni dogodek in medikalizacija ni vedno potrebna, a je pogosto rezultat zahtev porodnic in vpliva farmacevtske industrije. Kompozitni indeks medikalizacije poroda, sestavljen iz devetih indikatorjev med letoma 2000 in 2012 kaže, da se je stopnja medikalizacije poroda v Sloveniji glede na leto 2000 do leta 2012 povečala za 80,3 %, na Finskem za 30 % in Norveškem za 18,3 %. V primerjavi z obema državama je v Sloveniji od leta 2000 najbolj porasla aplikacija antibiotikov ob porodu, število epiduralnih analgezij in carskih rezov. Trend rasti carskih rezov pri prvo in drugorodnicah nakazuje, da se bo ta trend nadaljeval tudi v prihodnje. Medikalizacija sama po sebi ni ne dobra ne slaba. V 21. stoletju bi bilo nepredstavljivo, da bi nekatere bolezni ali stanja povsem demedikalizirali in jih s tem vrnili v čas naravne danosti, visoke umrljivosti ali družbene stigmatizacije. Ugotovitve teoretičnega in empiričnega dela osvetljujejo medikalizacijo nosečnosti in poroda z različnih perspektiv.
Keywords:medicina, porodništvo, babištvo, zdravje žensk, nosečnost, porod, medikalizacija, indeks medikalizacije poroda, družbene dimenzije
Year of publishing:2016
Publisher:M. Prosen]
Source:[Maribor
UDC:316:618.2/.7(043.3)
COBISS_ID:22275848 Link is opened in a new window
NUK URN:URN:SI:UM:DK:GKJQNA8E
Views:1547
Downloads:386
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Categories:FF
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Secondary language

Language:English
Title:THE SOCIAL CONSTRUCTION OF MEDICALIZATION OF PREGNANCY AND CHILDBIRTH
Abstract:Medicalization is a socio-cultural process in which non-medical problems are defined and treated as medical ones. It is a type of normative social process which encompasses an ever greater number of physiological phenomena, including pregnancy and childbirth that are not only biological but also cultural and social events. This doctoral thesis discusses the medicalization of pregnancy and childbirth in the broader social context of developing childbirth practices. The theoretical part explains the medicalization process using an example of pregnancy and childbirth and concludes by identifying childbirth medicalization indicators. The aim of the research’s empirical part was to comprehensively study the phenomenon of pregnancy and childbirth medicalization using a combination of qualitative and quantitative methods. For this purpose, the following research questions were formulated: how do women perceive and accept the medicalization of pregnancy and childbirth from their own experience and what is their attitude to natural childbirth; how do healthcare professionals who provide healthcare services to women perceive and experience the medicalization of pregnancy and childbirth as well as natural childbirth; what is the difference in the level of medicalization between Slovenia and other selected countries? In the framework of the qualitative methodology, the narrative method and the phenomenological study were used, whereas the quantitative methodology consisted of the method of secondary data analysis. The stratified purposive sample of the narrative method consisted of 19 birthing mothers while the purposive sample of the phenomenological study comprised 16 midwives and 4 obstetricians. In the secondary data analysis, apart from Slovenia the convenience sample included Norway and Finland. The data obtained with the narrative method and analyzed using the content analysis method present, through four main themes, the childbirth practices, beliefs, and traditions embedded in institutional childbirth; the responses of pregnant women to monitoring and detecting deviations during pregnancy; and the representations of motherhood and decision-making autonomy. It is evident from childbirth stories that the experience during first labor is the most decisive and at the same time the most educating experience for a birthing mother. The actions of birthing women are mainly guided by childbirth-related risks they have learned about from healthcare professionals, close family members, social networks, and the media. Based on the results of the phenomenological analysis made following Colaizzi, which was conducted separately for midwives and obstetricians, 12 thematic groups were formed for midwives and 11 for obstetricians. They are both aware that childbirth is a natural process and medicalization is not always necessary but is often the result of birthing mothers' requests and the influence of the pharmaceutical industry. Consisting of nine indicators, the composite childbirth medicalization index shows that the level of medicalization of childbirth in Slovenia increased by 80.3% between 2000 and 2012, while in Finland and Norway it rose by 30% and 18.3%, respectively. Compared to both of the abovementioned countries, in Slovenia applications of antibiotics during labor as well as the number of epidural analgesia and Caesarean sections increased the most since 2000. The upward trend in the number of Caesarean sections in first- and second-time birthing mothers shows that the trend will also continue in the future. Medicalization in itself is not considered bad or good. It is unimaginable that in the 21st century some diseases or conditions could be completely demedicalized and returned to the times of the natural state of affairs, high mortality or social stigmatization. The findings of the theoretical and empirical parts shed light on the medicalization of pregnancy and childbirth from different perspectives.
Keywords:medicine, obstetrics, midwifery, women’s health, pregnancy, childbirth, childbirth medicalization index, social dimensions


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