Decentering care for mothers: the politics of midwifery and the design of Finnish maternity services
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Åbo
Åbo Akad. Förlag
2001
|
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | Zugl.: Åbo, Åbo Akad., Diss., 2001 |
| Beschreibung: | XIII, 290 S. graph. Darst. |
| ISBN: | 9517650663 |
Internformat
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Datensatz im Suchindex
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|---|---|
| adam_text | CONTENTS
Table of contents v
List of figures and tables ix
List of abbreviations x
Acknowledgements xi
PART I: INTRODUCTION
1. A CONTESTED DOMAIN 1
1.1 State sponsored maternity care services in Finland 3
1.2 Highlighting midwifery in maternity services 8
2. RESEARCH PERSPECTIVES ON MATERNITY SERVICES
AND MIDWIFERY 11
2.1 The early critique of maternity care in context 12
2.2 The take over thesis challenged 15
2.3 Midwives and the Finnish birth movement 20
2.4 Sociology of midwifery and gendered professional projects 23
2.5 The welfare state, service policy and professional interest groups 26
PART II: CRITICAL JUNCTURES IN THE FORMATION OF
THE FINNISH MATERNITY SERVICES
3. ANALYSIS OF THE DESIGN OF THE
FINNISH MATERNITY SERVICES 35
3.1 Study of health service policy 36
3.2 Operationalizing the multiorganizational field 40
3.3 Looking at service design and interest group action 41
3.4 Occupational governance 43
3.5 The research questions 45
v
4. DOCUMENTARY RESEARCH ON HEALTH SERVICE
POLICY: JUNCTURES AND CONTEXT 46
4.1 Why documentary research on organizations 47
4.2 A grounded approach to collection of documents 49
Selection of documents 50
Identification of critical junctures 51
4.3 Triangulation in the analysis of documents
4.4 Presentation of primary data: Official policy documents 59
Documents on policy formulation 60
Documents on policy decision making 61
4.5 Presentation of primary data: Professional journals 61
The journal of the Finnish Federation of Midwives 63
Medical journals 66
The journal of the Association of Finnish Public Health Nurses 69
4.6 Presentation of complementary data: contemporary policy related
materials 70
4.7 Presentation of complementary data: secondary sources 71
Memoirs of policy entrepreneurs
Sources on the history of the Finnish maternity service and
midwifery 72
Interviews with health professionals and experts 73
5. COMPETING INTERESTS IN THE RISE OF
PREVENTIVE SERVICES 79
5.1 Urban and rural division in birth assistance 80
5.2 Midwives become an interest group 84
A public service for rural areas 86
5.3 Social or educational provisions for mothers? 89
5.4 The medical division of labor in maternity care 94
5.5 The Maternity Educator design 100
5.6 A municipal maternity service 108
Midwifery Service Design 111
vi
6. MATERNITY SISTERS IN NATIONAL SERVICE 118
6.1 The implementation of the midwifery service design 119
6.2 Mid vives as mother s friends 125
6.3 A comprehensive plan for a municipal health system 130
6.4 Pronatalist concerns and service design for the maternity services 134
Suomen Huolto 135
The Population Committee 136
6.5 The national maternity and child health service 139
6.6 New licensure for midwives 144
Midwives need to be promoted 145
Maternity sisters 149
7. THE RISE OF A WELFARE STATE HEALTH SERVICE:
MATERNITY CENTERS REVOKED 154
7.1 The implementation of the MCH service design 155
7.2 Challenges to occupational governance within the MCH service 160
Towards a reform of midwifery training 162
7.3 Rise of welfare state health policies 167
Plans to reorganize the municipal health services 170
The Public Health Act 174
7.4 Service design concerning the care for mothers embedded in
the Health Center Design 178
Molding a new professional 182
7.5 The dividing of the municipal sisters 184
8. SERVICE DESIGN FOR MATERNITY SERVICES IN
A DECENTRALIZED HEALTH SERVICE 193
8.1 Implementation of the PHA on Maternity Services 194
Maternity centers and the central hospitals 198
8.2 Reconstructed MCH service as a low policy design 202
Rise ot a new mission tor maternity services 204
8.3 Decentralization of health policy making 207
Reorganization of the provision of municipal health services 209
Health center physicians and the PRPC reform 210
Service design for the maternity services 213
8.4 Competing professional interests 215
Public health nursing re modeled 217
Debate on risk management in the maternity service 220
8.6 The reformed midwives still outsiders 222
vii
PART III: DECENTERING CARE FOR MOTHERS
9. THE DESIGN OF FINNISH MATERNITY SERVICES AND
THE POLITICS OF MIDWIFERY 233
9.1 Patterns of sendee designs 234
Midwifery Service Design 237
National Maternity and Child Health Service Design 239
Health Center Sendee Design 240
Population Responsibility Service Design 242
9.2 Midwifery as a sendee 243
9.3 Weaker women s professions , stronger generalists 247
9.4 The formation of a public primary care sendee 249
Municipalities and diluted high policy 251
10. THE INTERTWINED HISTORIES OF WELFARE POLICIES
AND PROFESSIONAL PROJECTS 254
10.1 Finnish health sendee policy 254
10.2 Welfare policy, the politics of midwifery and sendee design 256
REFERENCES 260
viii
List of figures and tables
Figure 3.1 The multiorganization in the organization of
welfare services 36
Figure 3.2 Multi dimensional field of countervailing powers
framing health care markets 37
Figure 3.3 The multiorganization of the provision of
welfare services 39
Figure 5.1 The Maternity Educator Low policy Design 106
Figure 5.2 The Midwifery Service High policy Design 112
Figure 6.1 The Maternity Center Low Policy Design 123
Figure 6.2 The National Maternity and Child Health
High policy Design 141
Figure 7.1 The low policy based proposal on allowing combined
midwife public health sister officials in small municipalities 161
Figure 7.2 The Health Center High Policy Design 183
Figure 8.1 Maternity centers as a field organization to
central hospitals 199
Figure 8.2 The reconstructed MCH service 204
Figure 8.3 The Population Responsibility High Policy Design 214
Figure 9.1 The four high policy service designs that have
restructured the Finnish maternity service 236
Table 1.1 The proportion (%) of pregnant women who have used
the Finnish maternity service, 1939 1995. 6
Table 4.1 Texts that document midwives1 views of the organization
of maternity services and midwifery collected from Katilolehti,
by type and period. 65
Table 4.2 Texts selected from professional journals reflecting the
interest group action of health center physicians, gynecologists
and public health nurses 1989 1993. 68
Table 5.1 Maternity care 1900 1930 in selected urban locations a
nd adjoining coundes 81
ix
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| spellingShingle | Wrede, Sirpa Decentering care for mothers the politics of midwifery and the design of Finnish maternity services Sozialpolitik (DE-588)4055879-4 gnd Geburtshilfe (DE-588)4019604-5 gnd Mutterschaftshilfe (DE-588)4120779-8 gnd |
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| title | Decentering care for mothers the politics of midwifery and the design of Finnish maternity services |
| title_auth | Decentering care for mothers the politics of midwifery and the design of Finnish maternity services |
| title_exact_search | Decentering care for mothers the politics of midwifery and the design of Finnish maternity services |
| title_full | Decentering care for mothers the politics of midwifery and the design of Finnish maternity services Sirpa Wrede |
| title_fullStr | Decentering care for mothers the politics of midwifery and the design of Finnish maternity services Sirpa Wrede |
| title_full_unstemmed | Decentering care for mothers the politics of midwifery and the design of Finnish maternity services Sirpa Wrede |
| title_short | Decentering care for mothers |
| title_sort | decentering care for mothers the politics of midwifery and the design of finnish maternity services |
| title_sub | the politics of midwifery and the design of Finnish maternity services |
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| topic_facet | Sozialpolitik Geburtshilfe Mutterschaftshilfe Finnland Hochschulschrift |
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