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MA/PhD Theses Abstracts of Current Students & Alumni |
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Jevitt, Cecilia Marie, August, 1994 - THE MAKING OF A MIDWIFE: THE CULTURAL CONSTRUCTIONS OF BRITISH MIDWIFERY AND AMERICAN NURSE-MIDWIFERY
Abstract: This descriptive study used critical medical anthropological theory to explore the historical, sociocultural, political, and economic variables that shape a national construction of midwifery. The study consisted of key informant interviews of British-educated midwives working in the United States and participant observation experiences in the United States during 1989 through 1993. Observation and key informant interviews were continued in the United Kingdom at 17 sites during July 1992. Transcripts from journals, notes, and recordings were copied and sorted by variables for analysis. Control of British midwifery include national certification, registration, and unionization. American nurse-midwifery is controlled at the state and individual hospital levels. The British government bears the cost of midwifery education and certification. American education, certification, registration, and liability insurance costs are born by individual nurse-midwives. British midwifery practice occurs within a single payor, single employer system. Health care providers are salaried and midwifery is legally independent. American nurse-midwives are employed by numerous employers and are reimbursed by numerous funding sources. American nurse-midwifery is legally controlled by biomedicine. British midwives of all educational backgrounds are integrated into a single midwifery system. American midwives of differing divides American birth into normal and abnormal domains, limiting nurse-midwifery care to the normal domain. The study concluded that the core cognitive domain of British midwifery is location of practice: community, hospital, or independent. American nurse-midwives organize midwifery according to funding sources: public or private. The study recommends that principles from both constructions of midwifery be studied for application cross-culturally to increase the effectiveness and efficiency of midwifery practice.
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