Physiological Birth in Poland – political and sociomedical context

Topic area. In the presentation, we will describe changes in the perinatal care and midwives’ professions from the perspective of the sociology of health and illness and sociology of the professions.Theoretical... [ view full abstract ]

Topic area. In the presentation, we will describe changes in the perinatal care and midwives’ professions from the perspective of the sociology of health and illness and sociology of the professions.

Theoretical perspective. To analyze the perinatal care in Poland we use the medicalization theory (P. Conrad, R. Davis-Floyd), the theory of social changes (P. Sztompka) and the theory of professions and healthcare organization (C. Benoit). Based on the last one social position of midwifery occupation is indicative for women’s gender citizenship. It reveals fundamental societal assumptions concerning women both as professionals, and subjects eligible for medical care (Benoit).

Underpinning theories.  The feminist perspective gives additional arguments to understand the reasons of some changes (R. Davis-Floyd, B. Katz Rothman). The civil society theories also are referenced.

Argument to be made. In the presentation, we would like to show changes in the perinatal care in comparison to the social changes which occurred after system transformation 27 years ago. An important issue relating to perinatal care is a political decision. The government presented new solutions in this area last time which could transform this care.

Discussion. The process of the transformation entailed the necessity of introducing new legal solutions. Besides socio-economic transformations, different forms of self-government also developed (local and professional), non-governmental organizations and many civic initiatives came into being. During the last two decades there were also many changes directly connected with the midwife profession and perinatal care, e.g. introduction of the Nurses and Midwifes Self Government Act, Standards of perinatal care during the physiological birth, establishment of professional associations, medical universities started to educate midwives, development of private health service, increase of proportion of births with a partner, ”opening” of hospitals, changes connected with more subjective patient’s treating. Simultaneously the medicalization process of the perinatal care is observed. There are 43% of cesarean sections, a lot of medical interventions during the labour are performed (e.g. induction or stimulation).  

conclusion

 Political transformation influences perinatal care and can be a threat to the developed standard of the parturient care. Strengthening the social control is a key factor guaranteeing the positive development in the parturient quality improvement will be sustained.