Mother and Baby Are Fine - A Qualitative Study on Marginalization, Gender Sensitive Healthcare and Quality in Swedish Obstetric Care

Abstract: In recent years, insufficient obstetric care has been a highly debated topic in Swedish media and politics. However, despite reports on e.g. the country’s high prevalence of birthing injuries, the recent closing of numerous maternity wards and a severe lack of midwives, the development of Sweden’s medical birth outcomes has been stable. Thus, based on the assumptions that (I) said quality measurements do not include all relevant factors and (II) patriarchal societal structures impact on how quality of care is defined, this thesis investigates the concept of quality of care in the context of Swedish obstetric care from a gender sensitive healthcare perspective. With regard to the theoretical framework, a qualitative study is conducted combining semi-structured expert interviews and textual content analysis. The study’s results indicate that Swedish obstetric care is in the process of medicalization, manifested in a shift from soft, traditionally female, to hard, patriarchal parameters and resulting in a pathologization of healthy, female bodies. In combination with the structural normalization of perineal injuries and a distinct lack of continuity of care in postnatal care, Swedish obstetric care does not live up to the relevant six criteria of gender sensitive healthcare. As external factors, such as strained working conditions for midwives, play a crucial role in these developments, the thesis concludes the distinct needs for nationwide guidelines for obstetric care and childbirth in order to ensure adequate healthcare for women. Finally, the concept of quality of care in the context of obstetric care needs to be reconsidered to include soft parameters such as women’s experiences.