Midwives struggle for recognition: a constructivist grounded theory study
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The University of Manchester United Kingdom
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1737
Midwives are a cornerstone in women’s reproductive care and vital to achieving sustainable maternal and neonatal development goals. After the enactment of a bill that allows abortion under three clauses, midwives have managed to expand their scope of practice to include induced abortion care. In this new scenario, this study aims to elucidate how Chilean midwives understand and provide abortion care and how they have (re)defined their professional identity to include abortion care.

The study followed a constructivist grounded theory methodology using in-depth online semi-structured interviews. Midwives were purposively and theoretically sampled until data saturation was reached. Fifteen Chilean midwives working in various settings and with various years of working experience were interviewed. Interviews were recorded, transcribed verbatim in Spanish and translated into English. Interviews were read and reread by the research team and coded incident-by-incident using NVivo. The team discussed the categories’ properties and relations to each other. A model using constructivist grounded analysis and Honneth’s recognition theory was generated to explain Chilean midwives’ understanding of their professional identity and experience providing abortion care.

The preliminary analysis of this study shows that 1)Chilean midwives understand abortion care provision as part of midwifery care. However, midwives are also aware of the contradictions of their practice. 2)Chilean midwives agree that midwifery’s scope of practice has moved from pregnancy and childbirth only to providing sexual and reproductive health care in broader terms. 3)Midwives’ autonomy is restrained by the healthcare systems current structure and laws regulating healthcare. Chilean healthcare provision continues to favour medics over non-medical professionals, creating tensions that fuel midwives’ struggle for recognition and their ability to provide optimum care.

Examining midwives’ experiences as a call for recognition could help to reduce midwives’ dissatisfaction and secure better future access to sexual and reproductive healthcare in Chile.

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