CARE-study into maternity and midwifery

Symbolically, for 9 months a group of committed researchers cooperated closely to write a grant proposal for a research project into ethical controversies in the mother-midwife relation during childbirth. This CARE-study (Controversies surrounding Autonomy and Responsibility: a care-Ethical study into the mother-midwife relation) is now granted, which means that a young and gifted researcher, philosopher and midwife Rodante van der Waal, is funded to perform her four year PhD study. Next to an empirical research into the advancements of respectful maternity care, the project involves a philosophical study into the ontology and history of pregnancy, childbirth and midwifery care. The project will be performed at the University of Humanistic Studies (Utrecht, The Netherlands) under the supervision of prof dr Carlo Leget. I am proud to be involved in this as co-supervisor.

Matrescence: changes in the mother and father brains

Matrescence is the term coined by anthropologist Dana Raphael in 1973 for the fundamental changes women go through when becoming mothers. She compares it to the other, common, and well described transition to adulthood: adolescence. In this Ted talk reproductive psychiatrist Alexandra Sacks reinvigorates this term for her own practice. She tells that postpartum women are calling her, saying that motherhood ‘isn’t supposed to feel like this’. They feel discomfort and wonder whether they have a disease. ‘Matrescence’ to her is helpful to describe the transition to motherhood, e.g. the normality of it. It is amazing how little we know about it in common life as well as in academia.

The same amazement is expressed in this Dutch TV-show by brain researcher Elseline Hoekzema, neuro endocrinologist Peter Bos and pedagogue Marian Bakermans, who researched both mothers’ and fathers’ reaction to becoming a parent. At delivery women do have a head start to fathers because of hormonal changes during pregnancy. Their brains show substantial differences that remain for two years, and never disappear completely. However, if fathers are (substantially) involved in babycare, they can easily catch up in becoming attentive, responsive parents. This is not what a few days of father’s leave can help accomplish, I think.

Interesting: women who are mothers are still quite ‘terra incognita’ for research, and what traditionally has been reduced to a gender or hormonal difference can now be refuted: it is an involvement in practices of care that makes the difference.

Care ethics: adequate for midwifery

With great interest I have read this study by Elizabeth Newnham and Mavis Kirkham who develop a care ethical outlook on midwifery as adequate alternative to bioethical and medical emphasis on respect for autonomy. The authors argue convincingly that the concept of autonomy is as such inadequate in ethical questions in midwifery care. Not only is a relational instead of an individualistic view required, as the pregnant woman is two-in-one, also autonomy does not represent the actual obstetric practice that already focuses on the unborn and is not free from paternalism. Hence attention and arguments for autonomy in everyday midwifery practice seem to be primarily rhetorical. An adequate alternative, the authors claim, is care ethics as it uncovers power relations (instead of covering them up) and focuses on concrete relational practices rather than abstract principles. A view that importantly underpins our research.