BMJ 2002;325:43 ( 6 July )

Letters

Evidence based leaflets in maternity care

    Compliance, coercion, and power have huge effect in maternity services
    Provision of information is only one component of informed choice
    Voluntariness must be ensured in prenatal screening

Compliance, coercion, and power have huge effect in maternity services

The first 150 words of the full text of this article appear below.

EDITOR---The midwives from Sheffield show the insight that a qualitative study can provide when coupled with a more controlled empirical investigation. 1 2 Both the studies and the accompanying editor's choice suggest that inequalities in power and status in the maternity services have a greater influence on what happens to women giving birth than either their hopes and dreams or the choices they feel informed to make.3

These studies are a powerful reminder that the physiological birth process without some degree of technological interference and tampering is rare. Midwives are portrayed in this hierarchical system as having little effect on the outcome of care. The authors suggest that when women can form a trusting relationship with a midwife they are more likely to ask questions and feel that they can make choices about their care, rather than simply being compliant.

As members of a national consumer movement in Australia, we . . . [Full text of this article]
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