Mothers and Midwives

Faye Thompson has thirty years experience as a midwife and educator. She studied philosophy and the humanities as an undergraduate in Australia, and now lectures on health care ethics. As a feminist, she seeks to reunite morality and personal interest so that the woman is not subordinated in women's healthand childbirth practices.

• ForewordAcknowledgementsGlossary of terms and context of analysisGlossary of termsContext of the analysisIntroductionReferencesCHAPTER 1: The need for a midwifery ethic of practiceThe metaphorLooking for the pool of ethics: a personal journeyWays of seeing: ways of actingThe social construction of our worldThe nature of 'practice'ReferencesCHAPTER 2: On the sealed highway - mainstream ethics, medicalisation and midwiferyThe nature of midwifery practiceThe influence of moral philosophy, and nursing ethicsMoral philosophy and mainstream ethical frameworks available to midwivesWhy midwives would be turning to mainstream ethical frameworksSummaryReferencesCHAPTER 3: The false trail - a critique of bioethics and the problem-solving approach for midwifery ethicsBioethics - its development and critics (the pool of ethics)Casuistry and contextQuandary or dilemma-based ethicsContextualismA critique of the normative, dilemmic/problem-solving approach of bioethics for midwiferyWhen the situation is stripped of contextWhen the subject is depersonalisedThe abstract nature of principlesWhat is ethically 'good'?Prior ethical practice , character, virtues and relationshipsSummaryReferencesCHAPTER 4: Midwifery's detour through nursing ethics - a critique of professional codes and influences that shape the midwifery ethics discourseTraditions of a professional practice, institutionalisation, and application of a codea critique of ethical codesPerceived strengths of codesPerceived weaknesses of codesHow ethical discourse in midwifery is shapedEducational curricula and their ethical orientationThe workplace setting and institutional influenceText books, journals and conference presentations: their ethical orientationCHAPTER 5: Off the beaten track - feminist virtue ethics and midwiferyValues and assumptions of feminist theory - epistemology and ontologyA feminist approach to ethics in midwiferyVirtue Ethics - context, character and relationshipNarratives, identity and traditionsThe public and privatePrivilegeDifferenceNormal/Abnormal - The impact of linguisticsMetaphors in childbirth reveal practice orientationSummaryReferencesCHAPTER 6: A conducted tour or independent travel? examining underlying assumptions and valuesOwners of the original knowledgeProfiles of those women telling their experiencesThe informant-researcher relationshipConstructing consensual meaningsMothers' and midwives' shared valuesPower in relationshipsPower 'over' - exploitative, manipulativePower 'for' - nutritivePower 'with' - integrativeSummaryReferencesCHAPTER 7: Facing obstacles along the way - mothers' and midwives' narratives of unethical childbirth practicesInstitutional dominancePaternalismLack of self-determinationFear, Safety, Mortality-Morbidity (negativity of attitude)Unsupportive of the womanProcedure-oriented approach; 'system workers'Values conflictWorkplace/service provider versus personal/professional midwifery ethicsNot valuing individualsEmotions/feelingsSummaryReferencesCHAPTER 8: Going to a comfortable place - the ethical voice of mothers and midwives'Being with' womanValues-VirtuesSupporting the womanKnowing the womanWoman's comfort: security, 'safe' for the womanWays of seeingMetaphors used by mothers and midwivesPersonal transformationSummaryReferencesCHAPTER 9: Checking our course - values and philosophical foundations of the midwifery professionThe philosophy and theory behind midwifery practiceWays of knowing: midwifery's epistemologyEthical theories and principles 'incorporated'Ways of seeing and construction: orientationPractitioner definitions of midwifery practicePractitioner identified philosophy of midwifery practice: values and beliefsSummaryReferencesCHAPTER 10: Plotting our practice - values and philosophical foundations of the birthing environmentThe power of languageBirth languageA concept analysis of normal labourPractice decisions and conflict between work place and personal/professional ethicsThe midwifery relationshipSummaryReferencesCHAPTER 11: The discourse of other travellers - literature on women's experiencesThe birth: women's experiencesThe midwife's approach: women's experiencesSummaryReferencesCHAPTER 12: Mapping a new ethic for midwives - from 'practice estate' to the pool and back, now a return journey travelled in tandemThe ethic of engagement - a midwifery ethicThe nature of engagement in ethical responses and relationshipsThe centrality of concepts which emerged from real life experience and literature, in an ethic of midwiferyImplications for practice and recommendationsReferencesConclusion