Gender Issues in Determining the Service and Research Agenda for Pregnancy and Birth Care: the Case of Home Birth in the Netherlands

Abstract

Worldwide, there are two conceptual models of pregnancy and child birth. In the first, ‘male’ model, pregnancy and the birth of a baby are biomedical processes. In the second, ‘female’ model, pregnancy and child birth are major psychosocial events for the woman. The research agenda of obstetri- cians is based on the biomedical model. It mainly focuses on studying the effectiveness of interventions aimed at diminishing the risk of morbidity and mortality. Midwives’ and nurses’ research agenda centres around ‘normal birth’ and takes psychosocial outcomes such as women's experiences and satisfaction with different types of care into account as well. Midwifery and nursing are relatively young fields of science. Research training and oppor- tunities are not as widely available to midwives as to obstetricians. As a consequence, the leading research into pregnancy and birth care focuses primarily on the application of technical, medical, ‘male’ solutions. A grow- ing body of evidence, however, shows that a healthy baby alone is not enough to guarantee a woman's satisfaction with her pregnancy, birth and postpartum period. To improve women's and babies’ well-being, the biomedical and psychosocial models of pregnancy and birth need to be reconciled and integrated.