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Biomedical subjects

Kathleen Fahy

Publications and source records attributed to Kathleen Fahy.

9 recordsLinked to original sources

An Australian history of the subordination of midwifery.

This paper analyses the history of the subordination of midwifery to medicine and nursing. With the important exception of Evan Willis' work on medical dominance and Annette Summers' work on the takeover of midwifery by nursing, other histories of Australian midwifery have taken a neutral approach to issue of power and control. The aim of analysing this period is to identify the strategies of power that were used to subordinate midwifery. With increased consciousness of how power has operated in the past, midwives and woman of today can be more empowered when seeking to promote normal birth and midwifery models of care. Concepts of 'power', 'the state' and midwife are defined and discussed. A summary of the decline of midwifery and the rise of obstetrics in Europe and the United Kingdom (UK) gives a background against which to understand the Australian experience. The historical account given here draws to a climax by focussing on the period 1886-1928. It was during this time that medicine forged an alliance with nursing and achieved both legal and disciplinary control of midwifery. Knowing how this was done is important because it helps us to recognise the power strategies that are currently being used by medicine. This is helpful when planning how these strategies might be matched or countered by contemporary woman and midwives when seeking to promote normal birth and midwifery models of care.

Australia↗

Enhancing nursing students' clinical placement experiences: a quality improvement project.

Clinical experience is recognised as the core of nursing education. Quality clinical placements across a variety of venues are vital to the development of capable and competent professionals. However there is evidence, both anecdotal and empirical, suggesting that students' clinical placement experiences are fraught with problems. The quality improvement project described in this paper aimed to improve the clinical learning experience of nursing students by strengthening communication and partnerships between the university and the two local health services. To achieve this goal, clinicians' perceptions of the problems related to clinical placements and their recommendations for improvement were explored. Focus groups, brainstorming sessions, personal interviews and surveys were used to collect qualitative and quantitative data. Problems and priority issues were identified as more than five hundred clinicians expressed their concerns, claims and issues. Key findings from the project are described under five themes: communication breakdown between the university and clinicians; mentorship; preparation for clinical placements; clinical competence; and graduates' readiness for practice. Utilising a quality improvement framework this project promoted vigorous debate and dialogue between university and health service partners. The nature and extent of the problems surrounding clinical placements were examined, high priority issues targeted for improvement, and the subsequent results measured through feedback from clinicians and students. The success of this project, although impressive in the early stages, will depend upon ongoing communication and evaluation to ensure sustainability of the improvements made.

Attitude of Health Personnel↗

Safety of the Stockholm Birth Center study: a critical review.

This paper critically appraised the validity and generalizability of the safety of the Stockholm Birth Center care study to determine if it can be relied on to answer the question, "Is primiparous labor and birth in a birth center as safe for babies as standard medical care?" The retrospective cohort study is summarized, and statistical and methodological aspects are evaluated. Errors that were identified include selection bias and two forms of performance bias, both involving the independent variable. Nondefinition and lack of control of the independent variable and minor statistical errors were also noted. More serious concerns relate to the validity of an intention-to-treat analysis. Some methodological problems reduced validity of the study and ability to generalize the findings to other birth centers. Birth center care is a desirable and established birth option. A more useful approach to improving maternity care provision could involve comparing multiple birth center sites with each other to find best practice so that it can be analyzed and duplicated.

Birthing Centers↗

Whose interests are served by the portrayal of childbearing women in popular magazines for women?

This research report addresses the question 'Whose interests are served by the portrayal of childbearing in popular magazines for women?'. The methodology was feminist content analysis using semiology. Sixty-nine womens' magazines of women's were assessed for analysis and four were finally selected because they represented a detailed description of women's thoughts and feelings about birth. This paper presents a single in-depth analysis as an exemplar of how childbearing is portrayed in popular magazine's for women.

Australia↗

Trusting enough to be out of control: a pilot study of women's sense of self during childbirth.

The findings of a pilot study undertaken to determine what features of childbirth have a positive effect on women's sense of self are presented in this paper. This research contrasted the midwifery and medical models of maternity care using feminist constructivism, personal narrative and a thematic analysis. Using theory that is strongly grounded in empirical data, this paper outlines the influence of features inherent in the woman's experience of childbirth that have been theoretically linked to how women feel about themselves. Primary focus was given to the internal characteristics that enable the woman to feel positive about herself during labour, birth and afterwards. The importance of the woman releasing mind control and allowing herself to move into an altered conscious state during labour is discussed in terms of women's subsequent enhanced sense of self. Results illustrate how women are more likely to trust enough to let go of mind control and release control of their bodies when supported within a midwifery model rather than when cared for in the medical model.

Adaptation, Psychological↗

Reflecting on practice to theorise empowerment for women: using Foucault's concepts.

The aim of this research is to understand how power operates in the medical encounter with the childbearing woman and to theorize ways in which midwives can empower women to experience control over what happens to them. Thirty-three Australian pregnant young women and the researcher participated in this study. A post-modern, feminist praxis approach was the research method used. Data was collected using participant observation, in-depth interviewing and reflective journaling. Data was analysed using Michel Foucault's theoretical concepts concerning disciplinary power/knowledge. Key theoretical findings are: knowing how power operates allows midwives to predict what will happen if the woman is intending to resist standardised medical birthing practices. When disciplinary medical power is used the purpose is to coerce patients to do what the doctor wants. Power and knowledge are inseparable, as each strengthens the other, thus Foucault writes of a single concept--Power/Knowledge. Medical power operates most effectively with the co-operation of the midwife and the submission of the childbearing woman. Medical power is normally invisible; it only becomes visible when resistance is encountered, whereupon rewards, threats and punishments are used in an attempt to gain submission. Women can be more empowered if the midwife shares knowledge, not just about pregnancy, labour and birth, but also about the woman's legal rights and what might happen if she decides to refuse standardised medical care. In this way women's empowerment can be facilitated so that they are more likely to experience the type of childbirth they desire.

Adolescent↗

The problems with the validity of the diagnosis of brain death.

The diagnosis of brain death as 'death' and organ transplantation have been closely historically linked since the mid twentieth century. It will be argued in this article that the development of a neurological definition of death was introduced to justify the removal of fresh viable organs for transplantation. Brain death cannot be diagnosed reliably using 'established practices'. Improved understanding of the pathophysiology of raised intracranial pressure has challenged our understanding of brain death. We need to move forward in our conceptualization of phenomenon of profound coma associated with massive brain damage. If examination for 'brain death' is to be carried out at all, there needs to be an examination and re-evaluation of practices and protocols.

Brain Death↗