Attitudes of Expectant Mothers Towards Male Midwives


Elaboration, 2018

54 Pages

Anonymous


Excerpt

Contents

Abstract

INTRODUCTION
Background to the study
Statement of the problem
Purpose of the Study
Research questions
Research hypothesis
Significance of Study
Scope of the study

LITERATURE REVIEW
Conceptual Review
Attitudes of expectant women towards male midwives in maternity unit
Socio-cultural beliefs of expectant mothers’ and attitude towards male midwives in the maternity unit of General Hospital, Calabar
Quality of care of male student midwives and attitude of expectant mothers’
Theoretical Review
Empirical Review
Summary of Literature Review

RESEARCH METHODOLOGY
Research design
Research setting
Target population
Sample size
Sampling techniques
Instrument for data collection
Validity/reliability of instrument
Method of data analysis
Ethical consideration

RESULTS AND INTERPRETATION

VARIABLES
Presentation of data by research questions
Hypotheses-by-hypothesis presentation data
DISCUSSION OF FINDINGS
Discussion of findings
Limitation of the study
Summary of the study
Conclusion
Recommendations
Suggestion for further studies

References

Abstract

The main thrust of this study was to investigate the attitudes of expectant mothers’ towards the care provided by male student midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria. To achieve the purpose of this study, three research questions were formulated for the study and two hypotheses were generated to direct the study. Literature was reviewed to find out the other researchers’ view about the topic under investigation. Descriptive research design was adopted for the study. A sample of fifty (50) expectant mothers was used for the study. The selection was done through consecutive sampling technique. The instrument for data collection was a questionnaire titled “Attitudes of Expectant Mothers’ towards Care Provided by Male Midwives Questionnaire (AEMCPMSMQ)”. The instrument was subjected to both face and content validation by the supervisor. The reliability estimate of the instruments was established through the Cronbach Alpha Reliability method. Simple percentage and Pearson Product Moment Correlation Method were the statistical analysis techniques adopted to test the hypotheses under study. All hypothesis were subjected to testing at .05 level of significance with relative degrees of freedom. The results of the analysis revealed that, quality of care of male midwives and socio-cultural belief of expectant mothers were significantly related to the attitude of expectant mothers toward male midwives in Maternity Ward of General Hospital, Calabar. Based on the findings of this study, it was recommended among others that female antenatal care providers should encourage expectant mothers to see male midwives as professionals who have been trained to provide quality care services in maternity ward and are guided by a code of conduct.

CHAPTER ONE

INTRODUCTION

Background to the study

Assistance in the birthing process has always been a prerequisite for expectant women with ancient writings containing evidence of female birth attendants with experience in childbirth who were women within or outside the family and were regarded as pioneers of midwifery practice. Midwifery is one of the oldest professions worldwide since the inception of human life. It was recognized as a female profession in ancient Egypt as indicated by the Ebers Papyrus dating 1900 to 1500BCE (Bwalya, Kolala, Mazyopa3, Mofya & Ngoma, 2015). Similarly, during the time of Hippocrates (460 to 410 BCE), it was thought that midwives in Athens ought to be required by law to have had children themselves (Nicopoullus, 2003). In the 16th century, midwifery which was exclusively practiced by old experienced women, later on became a profession of young women. Men joined the midwifery profession in the 20th century due to modernization (Fife, 2013). The term ‘midwife’ connotes to a woman who assists with childbirth. This definition essentially means that midwifery has since time immemorial been perceived as a profession for women. This is however changing as a number of men are entering the profession (Kennedy, Erickson-Owens & Davis, 2010). The last decade has seen an increase in universal recognition of the significance of male involvement in sexual and reproductive health matters specifically in high fertility countries. Until recently, men had been segregated from the midwifery profession as it has always been perceived as a female profession (Oyetunde & Nkwonta, 2014). However, while male midwives are gaining popularity, their acceptance is not unanimous (Alison, 2000). Some are of the opinion that the birthing room is not an area for men as they do not experience childbirth. There is also a belief that childbirth is outside the realm of male expertise. Critics of male midwives further cite the Bible, quoting Exodus chapter 1 verse 15-16, which mentions feminine names of Hebrew midwives, thus an indication that midwifery has always been a domain for women (Chilumba, 2014).

Many people sometimes wonder if there’s such thing as a male midwife. When the subject of men in midwifery is discussed, it usually conjures up perplexed looks. The very idea of men in midwifery can create quite a stir, and most laypeople don’t perceive it as strange that there are so few men in this profession. In fact, these conversations often lead to the unanimous sentiment that men shouldn’t be in this specialty at all. Scanning the web and reviewing blog discussions on this topic confirms that it’s a controversial idea, even among midwives themselves. It’s common knowledge that the profession of nursing is female dominated, and the challenges and complexities of this have been explored at length. In Nigeria for instance, the entry of men into midwifery has generated controversy over sex preference of midwives by expectant women. While Christian women may have a preference of being attended to by male midwives, Muslims perceive it as a taboo for men who are not their husbands to see their private parts (Azebri, Lawrence, Jimmy, Igbans, Apiakise & Ochiagha, 2015). Male midwives are further perceived as intruders into other men’s domestic territories. In case of the absence of a woman’s husband, the presence of a male midwife is seen as unsuitable and raises questions of inappropriate behaviour towards vulnerable female bodies as men themselves have never experienced labour pains and may be unable to interpret expectant women’s non-verbal cues. As issues of female modesty and male property emerge, most men prohibit their wives from being attended to by male midwives (Roberts, 2011). This study therefore, seeks to investigate the attitudes of expectant mothers’ towards the care provided by male student midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria.

Statement of the problem

Ensuring skilled attendance during child delivery is critical to guaranteeing successful birth outcomes for both the mother and baby. Worldwide, increasing attention is being put to the training of skilled birth attendants as a strategy towards the reduction of maternal and neonatal mortality rates (Walker, DeMaria, Suarez & Cragin, 2012). In the history of nursing, while the feminine pronoun has always been used while defining a midwife, it is acknowledged that changing midwifery trends also allow men to engage in the practice. Male midwives are, however, unacceptable in some cultures, a problem that has not been explored despite being a critical factor for midwife deployment (Roberts, 2011).

The current placement of midwives does not consider expectant mother’s preference. Rather, midwives attend nursing school as part of the development of human resource manpower and go back to their respective postings. Midwifery care is focused on personal and extremely intimate aspects of pregnancy and childbirth. The profession of midwifery is dominated by females with male midwives being greatly discriminated against not only by clients but also by female colleagues. There is also a belief that a man is not in a position to understand what a woman is going through in the course of pregnancy, labour and post-partum with some finding the motives of male midwives as suspicious (Kennedy, Erickson‐Owens & Davis, 2010). A number of expectant women are often uncomfortable with being assisted by male midwives during pregnancy and childbirth as well as they come from different cultural and religious backgrounds with different expectations from maternity staff. Since midwifery ought to be client focused, services should be provided with regard to the gender preferences of expectant mothers (Shavai & Chinamasa, 2015). It is against this that this study seeks to investigate the attitudes of expectant mothers’ towards the care provided by male student midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria.

Purpose of the Study

The main purpose of this study is to investigate the attitudes of expectant mothers’ towards the care provided by male student midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria.

The specific objectives will be;

1. To ascertain the attitudes of expectant mothers’ towards male midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria.
2. To determine the extent to which the essential qualities of male midwives influence the attitude of expectant mothers’ towards them in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria.
3. To assess the influence of socio-cultural beliefs of expectant mothers’ and their attitude towards male midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria.

Research questions

The study is designed to find relevant answers to the following questions:

i. What is the attitude of expectant mothers towards male midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria?
ii. To what extent does the quality services of male midwives influence the attitude of expectant mothers’ towards them in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria?
iii. How does the socio-cultural beliefs of expectant mothers’ influence their attitude towards male midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria?

Research hypothesis

In an attempt to answer the above research questions, the following statement of hypotheses will be proposed to guide the study.

i. There is no significant relationship between the attitude of expectant mothers and the essential qualities of male midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria.
ii. There is no significant relationship between the socio-cultural beliefs of expectant mothers’ and their attitude towards male midwives in the maternity unit of General Hospital, Calabar, Cross River State – Nigeria.

Significance of Study

Midwife gender preference by expectant mothers has unfortunately not been documented by most health care institutions for midwife deployment. This study thus sought to fill the existing information gap on midwife gender preference by expectant women for improved antenatal and postnatal care in health care institutions.

The existent state of affairs whereby male midwives undertake midwifery training but may not practice due to the culture of the areas they work is worrying. This essentially results in the underutilization of national human resources. Male midwives encounter sex-based discrimination from clients and female colleagues when performing their work. The findings of this study have added to the knowledge pool in gender studies as well as providing baseline information for much wider county specific studies.

Similarly, understanding the perceptions and attitudes of expectant women towards male midwives conducting deliveries in General Hospital, Calabar will essentially help in developing Information, Education and Communication (IEC) strategies that will help to encourage women in maternity units in Nigeria to utilize services provided by male midwives as a means of alleviating the shortage of human resource within the health sector.

The findings from this study will help in disabusing the misconceptions of people about male student midwives in maternity units and thereby, promote their acceptance and reduce maternal and foetal morbidity and mortality rate.

Scope of the study

The study is delimited to the Attitude of Expectant Mothers’ towards the care provided by male student midwives in the maternity unit of General Hospital, Calabar – Cross River State, Nigeria.

The study will also be confined to the following variables: attitude of expectant mothers, service quality of male student midwives, and socio-cultural beliefs of expectant mothers’ in maternity unit of General Hospital, Calabar, Cross River State – Nigeria.

Operational Definition of Terms

Attitude: This is a predisposition to respond positively or negatively towards an idea, object, person or situation which in turn influences an individual’s actions and responses.

Midwives: This refers to professionally trained and competent healthcare providers who attends to pregnant women during labour.

Expectant mothers: Pregnant women who are due to deliver and are accessing maternity care services.

Maternity care: This refers to care rendered by midwives to expectant mothers.

Male Midwives:

CHAPTER TWO

LITERATURE REVIEW

This chapter deals with a review of previous work done by other researchers in relation to the study under investigation. Therefore, the chapter will be presented under the following subheadings.

Conceptual Review

Attitudes of expectant women towards male midwives in maternity unit

Socio-cultural beliefs of expectant mothers’ and attitude towards male midwives in the maternity unit of General Hospital, Calabar

Quality of care of male student midwives and attitude of expectant mothers’

Theoretical Review

Empirical Review

Summary of Literature Review

Conceptual Review

God made childbirth as the privilege of the female folk. From this angle one can be justified to question the logic of males being midwives when they themselves will never experience the pleasures and pains of child bearing. Traditionally, maternal health issues have predominantly been seen and treated as a purely feminine matter. Women learnt midwifery through intuition and by taking care of themselves when pregnant and observing others giving birth. Fife (2013) reports that in the 16th century midwifery which used to be done by old experienced women, later became a profession of young women. Males joined midwifery in the 20th century due to modernization. However, problems arises when expecting mothers find themselves being asked to undress in front of a male midwife. According to Smellie (2011) culturally it is a taboo for men to attend to a birthing woman. McAllister (2012) reported that “patients are dissatisfied when their expectations are not realized”.

The Midwifery Act of 1952 prohibited men from training and practicing as midwives. However, in the late 1960s and early 1970s a small number of male nurses began challenging the idea that men cannot be midwives. In 1975 a bill to abolish sex discrimination in employment was introduced. This bill made it illegal for man to be discouraged from practicing as midwives. Later that year an amendment to the bill removed the barriers to men entering midwifery, provided certain restrictions were abided by.

As a result British lying-in hospital midwifery was allocated to train male midwives, but the male midwives were to be monitored to ascertain the suitability of men as midwives. This need for monitoring reflects stakeholders’ suspicion for males practicing as midwives. According to Alison (2011), the first men entered midwifery training in the British midwifery training schools in 1977. Speak and Aitken (2010) noted that by 1979 the "experiment" was deemed as being successful, and that "male midwives were generally acceptable to mothers, their husbands, midwifery and medical staff". In 1982 the Royal College of Midwives recommended that midwifery should be opened to men.

Nsululu (2013) a male midwife commented that “I qualified in 1997, and now work in a Midwifery Team working both in the community and the hospital environments. Currently (January 2001), I have been privileged in delivering 132 babies”. This shows that man also enjoy delivering babies. Men first won the right to be registered as midwives just 20 years ago, following a long legal battle. They faced opposition from female midwives and expectant mothers. Even today, not all women are comfortable with a man delivering their baby. Some are suspicious of men's motives while others reject them on religious grounds. Occasionally the woman's partner might decide that he doesn't want another man in the delivery room.

Taking into consideration the facts above one can deduce that although male midwives are happy to be in the labour ward, not all expecting mothers are comfortable with them. Health service delivery according to customer needs is compromised. In the modern period, midwifery began to change from being a female art into a male occupation, although the shift was not a smooth one (Allison, 2012). Roberts (2011) observed that a contributing factor in this shift of gender roles was Louis XIV’s use of male midwives to deliver his illegitimate children. As men delivered his mistresses babies, male midwives gained popularity. Allison (2012) agrees with Fife (2013) on the fact that the fight to include male midwives in the labour room was a struggle.

Attitudes of expectant women towards male midwives in maternity unit

Attitudes of expectant women towards male midwives according to Smellie (2011), is seldom a concern for some women. Though majority are often initially uncertain about being attended to by a male midwife, once rapport has been established gender ceases to be an issue. Some expectant women further assert that male midwives are more sympathetic and caring compared to their female counterparts. Also, it is relatively easy to convince women that the sex of a midwife is irrelevant provided they possess the skills and attributes required of all midwives. However, although male midwives are becoming more acceptable than in the past, not all women are comfortable with a man assisting in the birth of their baby (Chilumba, 2011). Some seem suspicious of men's motives while others reject them on religious grounds (Fife, 2013). A study by Duman (2012) on the attitudes and opinions of women in Turkey about male nurses who worked at the maternity and childbirth service, indicated that 90% of the women felt that nursing was a profession best suited for women, and that male midwives should not work in maternity wards. Participants further stated that they would prefer not to be attended to by male midwives during pregnancy and labour.

The presence of male midwives within a health care institution essentially means that women will not go for delivery services, a factor that mainly contributes to home deliveries. Mothers’ needs during pregnancy, labour and postpartum include emotional support, physical comfort and positive relationship provided by the attending midwife. Nurse-patient relationship is vital to gain a patient’s trust throughout this period. The existent state of affairs whereby male midwives undertake midwifery training but may not practice due to the culture of the areas they work is worrying. This essentially results in the underutilization of national human resources. Though feelings on both sides of the midwifery issue ran high, Jenkins in Fouche (2005) stated that he often gets a reaction from women and their families when he walks through the door, but he finds it easy to develop a rapport. Alan Jenkins in Fouche (2013) advised that "I think you have to try to understand each individual situation on the few occasions that happens, there could be religious reasons or it could be because women have been treated badly by men or it could be that the partner doesn't like the idea of a man handling her.” Fife (2013) commented that in defense, some people suggest that having a male midwife is no different from having a male doctor but it is. Midwifery is a much more intimate form of caring.

Socio-cultural beliefs of expectant mothers’ and attitude towards male midwives in the maternity unit of General Hospital, Calabar

There are reports of pregnant women who have expressed their discomfort with male midwives examining them during pregnancy and labour mostly based on personal, religious, and cultural grounds. In Egypt, where most women are Muslims, male midwives encounter rejection and lack of co-operation from pregnant women (Mthombeni, Maputle & Khoza, 2018). Shavai and Chinamasa (2015) found that most expectant mothers in Zimbabwe preferred female midwives and it was evident that there was an association between midwife gender preference and location. Mothers from rural areas, for instance, preferred female midwives. Consequently, older mothers preferred female midwives as they found it embarrassing and disturbing for male midwives, particularly young ones to attend to them while their younger counterparts did not mind male midwives. Factors contributing to the preferences included age, culture, and religious beliefs. Inoue, Chapman and Wynaden (2014) also found that some pregnant women refused the care given by male midwives and sometimes partners prohibited male midwives from participating in the delivery of their spouses.

The perception was that male midwives lacked birth experience and thus would not understand how women feel during labour. Duman (2012) elicited similar views regarding women in Turkey who rejected the care provided by male midwives on grounds that they would be embarrassed if procedures regarded as extremely intimate such as vaginal examinations, perineal care and catheterization were to be conducted by male midwives. Armstrong (2010) reiterates that some mothers react strongly to the idea of male midwives attending to them stating that they would rather deliver at home. About ninety per cent (93.3%) of women in his study felt that men were incapable of working effectively at a maternity unit due to societal stereotypical notions that only females have the ability to be good midwives. Smellie (2011) argued that childbirth is a life changing experience within all cultures and ethnic groups. It provokes a wide range of responses that are influenced by a complex interaction of different religious beliefs, culture, education, social status, economy and the perceived position of women within the society. According to Smellie (2011) at the centre of all these powerful forces is a unique individual with her own personality, needs, hopes and fears. Both the status and the perceptions of women are influenced by social class, education, religious beliefs and the degree to which the group has been exposed to different value systems. Roberts (2011) advocates that since midwives have a professional duty to offer equitable care according to clients’ needs, it follows that an understanding of the client's cultural background is a pre-requisite for satisfying the midwife gender preference of the expectant mother in any given situation. The current situation whereby male nurses are sent for midwifery training but may not practice because of the culture of the places they are working is disturbing. It leads to underutilization of national human resources. Smellie (2011) proposes that while many Christian women prefer male midwives because they say men are more attentive, Muslim women claim that it is against their religion for men other than their husband to see them naked. Some expectant mothers charged that male midwives often caused more problems than they solved. They lacked the natural tenderness that one woman has for another. Unfortunately they did not describe the nature of problems caused. However there are but too few midwives who are sufficiently mistresses in their profession.

According to Allison (2012) even though male midwives gained popularity, their acceptance was not unanimous. Some people believed that men did not belong to the birthing room; since men do not experience childbirth. Some believed that child birth is beyond the realm of male expertise. Such critics often cited the Bible Exodus chapter 1 verse 15-16, claiming the absence of men at recorded births. Roberts (2011) viewed male midwives as interlopers into other men’s domestic territory. In a space where the husband or father was absent, the male midwife’s presence stood out as inappropriate. It raised questions about the male midwives’ potentially inappropriate behavior toward vulnerable female bodies since males never experienced labour pains. The researchers cannot expect them to interpret the expectant mothers’ non-verbal communication. Thus issues of female modesty and male property emerged, and opponents called upon husbands to bar male midwives from their homes, thus male midwives were a potential source of problems with the spouse and other interested parties. Allison (2012) observed that in Papua New Guinea people adhere to their diverse cultures, so much that in one culture a woman can bleed to death in front of a male midwife, because she doesn’t want her private parts to be seen by a man. Women do not come to the antenatal clinic, because they don’t want to be seen by male midwives. When there are male midwives woman don’t come for delivery services. This observation shows that some expectant mothers are scared of male midwives. One can also attribute the fact that, some pregnant mothers are scared of male midwives, as a factor contributing to home deliveries in Zimbabwe.

Quality of care of male student midwives and attitude of expectant mothers’

The term midwife simply means “with woman,” and the midwifery model of care transcends gender. With the essential qualities of a midwife present, gender can fade to the background. These qualities include proper skills and training, a desire to serve women, and the ability to empathize and communicate. Even more critical, midwives must be good listeners. The quintessential midwife listens to women in order to cultivate a relationship that prioritizes their individualized needs. It’s this same philosophy of respect for diversity and individuality that underscores the need for a more accepting environment for male midwives (Bwalya, Kolala, Mazyopa3, Mofya & Ngoma, 2015). Recently, a qualitative study on diversity in midwifery found that male midwives encounter unique adversity, and may be singled out by women and other midwives as being “different” (Sengane M., 2013). Men interviewed in this study reported a sense of heightened personal awareness and increased respect for individuality due to their own minority status. Beingale (2003) was a facilitator to culturally competent care. The authors concluded that these male midwives displayed the precise qualities and philosophies that all midwives wish to embody (Sengane M., 2013). Keukam a female midwife who was attended by a male midwife at birth was cited in Smellie (2011) saying that she admires male midwives’ techniques so much that she strives to emulate them in her work. Smellie (2011) cited Stone an expectant mother saying “Male midwives are the best, female midwives are believed to be aggressive and impatient at times.” One would wonder if all the male midwives are good and most female midwives aggressive or inconsiderate. However gender is just not an issue, but the midwives need a certain personality to do the job.

Quality of care is a multidimensional concept with no universally accepted definition. Chaunie B. (2013) argued that quality of care encompasses “clinical effectiveness, safety, and a good experience for the patient”. In the case of family planning and reproductive health services, Bruce (1990) defines quality of care as comprising six elements: choice of methods, information given to clients, technical competence, follow-up and continuity mechanisms, interpersonal relations, and an appropriate constellation of services. Hulton et al., (2000) in relation to facility-based maternal health services, suggest quality of care is defined by effectiveness, timeliness, as well as the upholding of basic reproductive rights (EL-Sayed H. et al, 2013; Inoue, Chapman and Wynaden, 2014). In addition, quality is defined as comprising two components: the quality of the provision of care in relation to the service and the system, and the quality of care as experienced by users (Inoue, Chapman and Wynaden, 2014). Society now might be more accepting of male midwives than 20 years ago (Fife, 2013). It must be recorded that, not all women are comfortable with a man delivering their baby. Some are suspicious of men's motives while others reject them on religious grounds. Fife (2013:91) commented that “clearly, a better mix of midwives from varying racial, ethnic, and cultural backgrounds is needed”. Fife (2013) was silent on midwife gender. Smellie (2011) reveals that one male midwife succinctly stated that “gender is very rarely an issue for some clients.” Many women reported being initially hesitant about having a male midwife, but once rapport was developed gender was no longer a consideration. Furthermore, one woman reported that her male midwife was “much more caring and sympathetic” than her female midwives. Another midwife explained that if the male midwife has “the skills and attributes that midwives need, it doesn’t matter what the gender is and it’s usually pretty easy to convince women of that.” The overall emerging theme is that gender isn’t necessarily related to caring practices and men in midwifery credit the women they serve with the ability to discriminate the difference.

The attitudes and behaviours of maternal health care providers (MHCPs) are an important element of quality as they influence both positively and negatively how women, and their partners and families perceive and experience maternal health care. Lack of respectful care from providers, such as doctors and midwives, may lead to dissatisfaction with the health system, diminishing the likelihood of seeking antenatal (ANC), delivery and postnatal services (Pilkenton D., et al, 2012).

In addition, MHCP attitudes and behaviours might directly affect the well-being of patients and clients, and the relationship between patients and providers (Pilkenton D., et al, 2012). Moreover, negative attitudes and behaviours could undermine the quality of care and the effectiveness of maternal and infant health promotion efforts, in addition to compromising women’s essential right to dignified and respectful maternal health care (Bwalya, Kolala, Mazyopa3, Mofya & Ngoma, 2015). Taken together, the attitudes and behaviours of maternal health care providers are an important determinant of maternal and infant health outcomes (Holmes, W., 2012; Buttiens H., 2004).

Smellie (2011) posits that while a majority of Christian women prefer male midwives since they perceive them as more caring and attentive, Muslim women affirm that it is in contradiction of their religion for men other than their husbands to see them naked. Some expectant mothers indicted that male midwives seemed to cause more problems and lacked the natural tenderness of women. The author is also of the opinion that female midwives were incapable of undertaking any form of mischief compared to males. Male midwives are also perceived as habitually ignorant, rough and impatient, with stiff fingers and always set to use injury-inflicting instruments of their profession. Fife (2013) asserts that “a female midwife will employ, patiently and without stint, or remission, everything necessary to assist women during childbirth, with minimal pain.” Roberts (2011) and Fife (2013) express reservations about the impartiality of men, especially young men, when they have to manually examine expectant women in their diagnostic procedures. They observe that manual and visual examinations, which cannot be conveyed theoretically are essential in midwifery, and can only be perfected through personal experience. Most women who prefer the care of male midwives state that they found males to be more caring and sympathetic since they have not experienced labour and are thus gentler as they cannot imagine the magnitude of pain felt during birth. This is unlike women who may have been through childbirth and think, “I did it and lived, so this woman will too”. This fact was affirmed by Pilkenton and Schorn (2012) who opine that male midwives are more sympathetic and lack preconceived ideas of childbirth compared to their female counterparts who mainly base childbirth on their own experiences. Duman (2012) further states that some women do not mind being attended to by male midwives provided they are qualified and are accompanied by a female colleague. Finally, Bwalya, Kolala, Mazyopa3, Mofya and Ngoma (2015), in their study on the perceptions of pregnant women towards male midwives, posit that a majority (83%) of women in Zambia accepted care provided by male midwives as they were of the view that both females and males received similar training and thus provided the same care.

Theoretical Review

This study is based on the following theories.

The midwifery model of care

Structural functionalism theory

The Midwifery Model of Care

Proposed by the Queensland Nursing Council (2000), the midwifery structural model of care is used to inform an assessment of expectant mothers’ midwife gender preferences and includes nurturing, hands-on care before, during, and after birth. It identifies four elements in midwifery: the woman as the central focus, the midwife as the provider of care, the professional partnership and the environment in which care occurs. The midwifery model acts as a benchmark to midwives on areas to be deliberated on when changing a practice model. Midwives ought to develop trusting relationships with their clients, which will in turn result in confidence, trust and cooperation from expectant mothers. While midwives practise in various settings and are diverse with regard to gender and age, they are all taught to provide comprehensive antenatal and prenatal care, guide labour and birth, address complications, and care for newborns (Rooks, 1999). Midwifery, according to the Queensland Nursing Council (2000), does not occur in a vacuum. As such, the use of the midwifery model essentially encourages midwives in the recognition that the quality of client care is dependent on a variety of factors such as satisfying expectant mothers’ preference of midwife gender and respect of patient preferences, values and expressed needs.

Given that the midwifery model provides guidance for assessing the quality of patient care and how different practice models can be executed, it is best suited for use in evaluation of inclusion of men in midwifery as they are yet to be fully accepted by expectant women and female medical practitioners. The model further provides a logical structure to guide the decision making process of midwives as well as guidance on assessing quality midwifery care based on midwife gender.

Structural Functionalism Theory

This study was guided by the theory of functionalism. Also known as structural functionalism theory, functionalism originated from the works of Emile Durkheim, who had particular interest in the possibility of social order as well as how society remains relatively stable. It is thus focused on the macro-level of social structure, rather than the micro-level of everyday life. Notable theorists include Herbert Spencer, Talcott Parsons, and Robert K. Merton (Parsons, 2017). Structural functionalism tries to elucidate the reason society functions the way it does by focusing on interactions between various social institutions: education, family, media, religion, government and the judiciary. Each part of society is interpreted with regard to its contribution to the stability of the entire society (Crossman, 2018). Society is more than a summation of its parts; rather, each part is functional for the stability of the whole. An institution is only existent since it serves a vital role in the functioning of society. If fades once it no longer serves a role. Emergence of new needs results in creation of new institutions to meet them. With regard to attitudes held by expectant women towards male midwives, the interaction between different factors and social systems within the Maasai community such as culture, religion and education levels tend to affect the uptake of services provided by male midwives. Culture and religion may, for instance, prohibit expectant women from associating with male midwives due to issues of modesty and respect for a woman’s spouse. Also, a woman’s level of education essentially determines her level of open mindedness, whereby women with higher education levels are more open to using services provided by male midwives unlike those with little or no education. This is conceptualized in Figure 2.1 below. However, functionalism has been critiqued for its neglect of the negative repercussions of social order. Critics, like Italian theorist Antonio Gramsci, assert that cultural supremacy and the status quo are justified by one’s perspective which in turn preserves them. Also, functionalism does not embolden individuals to actively participate in changing their social environment, even when doing so could benefit them. Rather, functionalism perceives agitating for social change as detrimental since the many parts of society will naturally compensate for any problems that might arise (Crossman, 2018). Functionalism also assumes that all parts of society are strongly integrated into a single unit, with each part being functional for the rest. It also argues that if one part changes, it will essentially have an on effect on other parts of society. Crossman (2018), however, argues that some parts of society may be relatively independent from the rest, meaning that society would not collapse with the disappearance of one of its parts.

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Details

Title
Attitudes of Expectant Mothers Towards Male Midwives
Year
2018
Pages
54
Catalog Number
V539784
ISBN (eBook)
9783346178107
ISBN (Book)
9783346178114
Language
English
Tags
attitudes, expectant, male, midwives, mothers, towards
Quote paper
Anonymous, 2018, Attitudes of Expectant Mothers Towards Male Midwives, Munich, GRIN Verlag, https://www.grin.com/document/539784

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