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Institute of Biomedical Ethics and History of Medicine (IBME)

Master Thesis Ladina Kunz


Background: The medicalization of pregnancy and the high use of medical interventions during pregnancy and childbirth have become a controversial topic in the medical community. In Western countries, the predominant delivery model is medicalized birth. While this trend has helped to reduce infant and maternal mortality rates, some voices critique the overmedicalization of pregnancy, classifying it as a medical problem. The concept of woman-centered care and the debate over the appropriate level of medical care during pregnancy have gained increasing attention among health care providers. To provide quality care and promote maternal and infant well-being, women's experiences of pregnancy and childbirth must be considered. Critical factors in a woman's experience include her attitudes toward the medicalization of pregnancy, her personal definition of pregnancy, and her consequent choice of her preferred model of care. The purpose of the study highlighted in this thesis is to examine women's understanding and definition of pregnancy, the appropriate level of medicalization, and their preferred model of maternity care.

Methods: 37 women participated in a national qualitative study in Switzerland that included in-depth interviews. The women came from a variety of backgrounds and experiences. Key themes and patterns were found through thematic analysis following the DIPEX methodology. This study was conducted as a posteriori analysis of another study, where the aim was to understand women’s experiences with prenatal testing, that included further questions about the experience of pregnancy. 

Results: The findings underscore the importance of women-centered care and suggest that health care providers should support women during pregnancy and childbirth by considering the different needs of individual women and providing information so that women can make informed choices about their preferred models of care. Women want to choose the right level of medical care during pregnancy and childbirth according to their preferences. Furthermore, some women still experience situations of loss of autonomy and control over their bodies, indicating that there is room for improvement in the medical care of pregnant women in Switzerland. 

Conclusion: According to this study, women want to choose the degree of medical assistance during pregnancy and childbirth and the model of maternity care. They choose the midwife-based model of care when they look for emotional and psychosocial support and practical advices and the obstetrician-based model of care for professional counseling regarding decision-making about the management of mother’s and child’s health.