Introducing the Social Sciences for Midwifery Practice

Birthing in a Contemporary Society

Patricia Lindsay, Ian Peate

• Publisher: Routledge
• Year: 2015
• Print ISBN: 9781138015548
• eBook ISBN: 9781317744047
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

Introducing the Social Sciences for Midwifery Practice makes clear the links between social, anthropological and psychological concepts, midwifery practice and women's experience of birth. Demonstrating how empathising with women and understanding the context in which they live can affect childbirth outcomes and experiences, this evidence-based text emphasises the importance of compassionate and humane care in midwifery practice.

Exploring midwifery as an art, as well as a science, the authors collected here make the case for midwives as professionals working 'with women' rather than as birth technicians, taking a purely competency-based approach to practice. The book incorporates a range of pedagogical features to enhance student learning, including overall chapter aims and learning outcomes, 'recommendations for practice', 'learning triggers' to encourage the reader to delve deeper and reflect on practice, 'application to practice' case studies which ensure that the theory is related to contemporary practice, and a glossary of terms. The chapters cover perspectives on birth from sociology; psychology; anthropology; law; social policy and politics. Other chapters address important issues such as disability, politics and sexuality.

Outlining relevant theory from the social sciences and clearly applying it to practice, this text is an essential read for all student midwives, registered midwives and doulas.

1 Introduction to sociology

Kate Nash

DOI: 10.4324/9781315794280-1

Aim

The aim of this chapter is to offer an introduction to the subject of sociology and outline some of the main sociological theories and research methods used within sociological inquiry. It is hoped that through reading this chapter readers will begin to think more analytically about how societies function and consider the social influences that shape our own interpretations of the world and everyday social interactions.

Learning outcomes

By the end of the chapter the reader should be able to:

• Understand the relevance of sociology both as an academic discipline and its role in helping us to understand society today
• Explore the relevance of sociology for midwifery practice and theory
• Identify some of the main sociological theories
• Articulate some of the different theoretical approaches used within sociological research
• Summarise the key research methods used within sociological research
• Discuss the contribution of sociological research to midwifery knowledge

Introduction

As its name suggests the discipline of sociology involves the study of society and Giddens and Sutton (2013) define sociology as the scientific study of human social life, groups and societies. In particular, the British Sociological Association has emphasised how the study of sociology consists of trying to understand how society works by scrutinising different societies and the many forms of relationship that exist between groups and individuals both on a large and smaller scale (British Sociological Association, n.d.). It is through such scrutiny that we can appreciate how groups have formed and relationships established to provide the structure and culture within which we live and operate. This is generally acquired through the process of socialisation (Browne, 2011), which plays a vital part in how we form individual and group identities. Social control is the term given to the various methods used within societies to ensure that groups and individuals conform to established social values that have been learnt through socialisation. Sanctions are often used to achieve social control and both socialisation and social control help to maintain social order and ensure that groups conform to the expected codes and values of the group (Browne, 2011).

Trigger

Read The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives (Nursing and Midwifery Council, NMC, 2015). Online at: www.nmc-uk.org/Publications/Standards/The-code/Introduction/

Consider the standards that govern the behaviour and conduct of nurses, midwives and health visitors. How are these standards enforced and what are the possible consequences (or sanctions) imposed for midwives failing to conform to these standards?

This chapter is divided into two sections. Section one provides an overview of the major sociological theories and perspectives, while section two summarises the various approaches and methods used within sociological research and considers the relevance of sociological research for midwives today.

There are many divisions and categories that exist within the study of sociology and Sharp (2010) describes sociology as being multi paradigmatic, meaning that it has been shaped over the years by many different perspectives and interpretations. It is impossible within the constraints of this chapter to do justice to the intricacies and complexities of sociological theory and so the reader is directed to a variety of resources throughout this chapter should they wish to develop their study further.

Being able to understand and engage with research and evidence-based practice forms a vital part of midwifery curricula within the United Kingdom today. Closely linked with sociological theory, sociological research seeks to inform us about society and many of the research methods used within healthcare today have their roots in sociological inquiry. The second section of this chapter presents an overview of the different approaches used by those undertaking sociological inquiry.

Overview of the main historical sociological theories

Structural theories

In order to understand sociology it is important to view the development of sociology theory against the emerging background which it evolved to provide context and enable an understanding of its importance and relevance at that time. The term ‘sociology’ was coined by the French philosopher Auguste Comte (1798–1857). Comte made reference to the term sociology in his 1822 publication ‘Plan des travaux scientifiques nécessaires pour réorganiser la société’ or ‘terms of scientific work needed to reorganise society’ and is believed by many to be one of the original founders of sociology.

Comte was born at the end of the French Revolution and a period of eighteenth-century European philosophy known as the Age of Enlightenment. This period was identified as an intellectual movement that encouraged and advocated scientific investigation and political philosophical debate as a way to create an influential system of ethics, aesthetics and knowledge. Comte put forward a considerable argument for the justification of sociology as an academic discipline and presented a law of three states whereby he believed that society must progress through three periods of intellectual development: theological, metaphysical and scientific. Comte believed that this progression was the principal cause of social change and that was also reflected within the scientific development apparent at that time.

Comte’s philosophy subscribed very much to a positivist approach (Comte, 1854) and he proposed that the objective of positivism was to ‘generalise our scientific conceptions and to systematise the art of social life’ (Comte, 1854, p. 3). The traditional scientific or experimental approach to conducting research has its underpinnings in positivism (Robson, >2002) and positivists hold a fundamental belief in objective reality and the assumption that phenomena have antecedent causes (Polit and Beck, 2004). Comte argued that the study of sociology should be based on empirical evidence that was drawn from observation, comparison and experimentation and set out his proposal for a scientific method of organising experience.

Comte also suggested that society is a system whose parts are interconnected in ways that would have consequences for the maintenance of the social whole. Structural theories of society are described as having a macro perspective, whereby the focus is less on the specific actions of an individual but on the roles that they occupy and how these relate to each other and interconnect to form the whole (Sharp, 2010). When analysing roles the focus of structural theories is not on the individual occupying the roles but on the nature of the role itself and the expectations and standards expected by society of a particular role. This enables groups and organisations to be considered independently of the different people that constitute them (Sharp, 2010).

Trigger

Consider how midwives are viewed within society. You may wish to think about recent media coverage and terms used when describing midwives as a professional group. How might your own views of midwifery have changed since starting your midwifery training?

The two main structural theories are functionalism and Marxism. Functionalism is a branch of sociology that emphasises how different elements of society work harmoniously as a series of interconnected parts that together form a whole (Haralambos and Holborn, 2013). Social institutions such as the family are therefore analysed as a whole rather than as isolated components and it is believed that in order for such institutions to survive within society, there must be the fulfilment of necessary conditions of existence called functional prerequisites (Haralambos and Holborn, 2004). These functional prerequisites are based upon the socialisation of shared customs and values and various approaches have been used to identify what these are and the factors that different societies have in common. Thus functionalists focus on how social systems are maintained by the contribution of the specified prerequisites.

Functionalism became the dominant social theory within sociology up until the 1940s and 1950s and was developed by another French philosopher Émile Durkheim (1858–1917) who is widely regarded as one of the most influential functionalist theorists and important in establishing sociology as a serious academic discipline. Durkheim was active at a time when France was undergoing great social and economic upheaval and strove to consider how social groups could function together to form a cohesive society.

Often referred to as consensus theory, functionalism emphasises an essential consensus that should operate within societies and is particularly concerned with the maintenance of social order. Durkheim believed that the essence of human nature was twofold: partly driven by selfish desires and partly by an ability to believe in and adhere to moral values. By having a collective conscience comprising of shared beliefs and attitudes, Durkheim believed that it was possible for humans to become integrated into the dominant values of society and achieve social order. Like Comte, Durkheim adopted a positivist approach and focused upon the observable and the measurable as opposed to the internalised subjective experience.

Although Durkheim had little to say about healthcare, later functionalist sociologists sought to consider the various aspects of health and its management. Talcott Parsons (1902–1979) considered the concept of the sick role and argued that adhering to such a role helps to ensure the smooth running of society and ensure disruption is kept to a minimum. A criticism of the functionalist approach is its tendency to disregard conflict and play down the degree of independence that those inhabiting the role possess. There is also scope for exploitation within these roles as could be seen in the abuse of medical power and disempowerment of the patient or sick person (Sharp, 2010).

Application to practice

Consider the culture within the unit where you work. What are the shared values, beliefs and customs that you see being upheld within your day-to-day practice? How might these influence your behaviour and relationships with colleagues and women and their families?

By way of contrast, conflict theory or critical theory, which has its origins in the work of Karl Marx (1818–1883) has its roots in the economic conflicts that exist between social classes within society. Whereas consensus theory emphasises the importance of having a collective consciousness to facilitate harmonious integration within society, conflict...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of figures, tables and boxes
• Author biographies
• Acknowledgements
• Preface
• Foreword
• 1 Introduction to sociology
• 2 Application of sociology to midwifery
• 3 Psychology and midwifery practice
• 4 Anthropology and midwifery
• 5 Conformity and conflict in maternity services
• 6 Spirituality and midwifery care
• 7 Consent, choice and childbirth
• 8 Politics and birth
• 9 Social policy for midwives
• 10 The woman with a disability
• 11 Sexuality and midwifery
• Glossary
• Index