The face to face is not so innocent: into interpersonal spaces of maternal-infant care
Date
2008-09-16T19:07:19Z
Authors
Brown, Helen Jean
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Abstract
This qualitative inquiry sought to explore how relationships are experienced in every day moments of care provided to childbearing women, infants, and families. Fifteen health care providers and thirteen childbearing women were interviewed regarding the degree to which these relationships have impacts on women’s health capacities and outcomes of care. These experiences were examined within the context of the broader social and cultural contexts of maternal-infant care.
All twenty eight participants in the study were involved with an antenatal home care program and a neonatal intensive care unit within the Lower Mainland Health Authority in British Columbia. The epistemological and methodological approach to the study combined relational and pragmatist perspectives on knowledge and a deconstructionist hermeneutic lens. Findings indicate that participants’ experiences are created in each moment of interpersonal care, and the interactions between health care providers and child-bearing women are far from neutral in terms of their impact on women’s health capacities and outcomes of care. Clear distinctions in perspectives among the two groups emerged: the child-bearing women dismissed the use of the term ‘relationship’ in describing their experiences with health care providers. In contrast, health care providers spoke of their assumption that the basis of engagement was a supportive relationship, the primary vehicle through which neutral and impartial health care is provided. The findings detail that relationships are sites of meaningful experiences and can facilitate as well as constrain women’s agency and self-worth; some of these experiences jeopardized the women’s health capacities and outcomes of care as they endured health challenges in pregnancy and as they mothered their ill infants.
Although health care providers and childbearing women drew upon different discursive resources and features of two program contexts, a similar construction of knowledge and experience was evident within participants’ accounts. Whereas health care providers tended to speak with the grain of instrumental and sentimental discourses through a veil of neutrality, the child-bearing women spoke against the grain by resisting the notion that interpersonal spaces are necessarily sites of one-on-one individual interaction. Rather, the data suggests that interpersonal spaces are not individualized spaces. Experiences of relationship were broadly situated and shaped through the relational complexity of each moment of the interpersonal, where the cultural ‘scenes’ of maternal-infant care shaped relationships and constructed the women’s health capacities and outcomes of care. In this way, the face to face is not so innocent.
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Keywords
relationships, women’s health, health care providers