“Ashamed, Silent and Stuck in a System”—Applying a Structural Violence Lens to Midwives’ Stories on Social Disadvantage in Pregnancy

Eva Neely, Briony Raven, Lesley Dixon, Carol Bartle and Carmen Timu-Parata
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Eva Neely: School of Health, Te Herenga Waka—Victoria University of Wellington, Wellington 6140, New Zealand
Briony Raven: Maternity Equity Action, Haumoana 4102, New Zealand
Lesley Dixon: New Zealand College of Midwives, Christchurch 8014, New Zealand
Carol Bartle: New Zealand College of Midwives, Christchurch 8014, New Zealand
Carmen Timu-Parata: Ngati Kahungunu, Department of Public Health, Otago University, Wellington 6242, New Zealand

IJERPH, 2020, vol. 17, issue 24, 1-16

Abstract: Historical and enduring maternal health inequities and injustices continue to grow in Aotearoa New Zealand, despite attempts to address the problem. Pregnancy increases vulnerability to poverty through a variety of mechanisms. This project qualitatively analysed an open survey response from midwives about their experiences of providing maternity care to women living with social disadvantage. We used a structural violence lens to examine the effects of social disadvantage on pregnant women. The analysis of midwives’ narratives exposed three mechanisms by which women were exposed to structural violence, these included structural disempowerment, inequitable risk and the neoliberal system. Women were structurally disempowered through reduced access to agency, lack of opportunities and inadequate meeting of basic human needs. Disadvantage exacerbated risks inequitably by increasing barriers to care, exacerbating the impact of adverse life circumstances and causing chronic stress. Lastly, the neoliberal system emphasised individual responsibility that perpetuated inequities. Despite the stated aim of equitable access to health care for all in policy documents, the current system and social structure continues to perpetuate systemic disadvantage.

Keywords: maternal health; structural violence; equity; social disadvantage; pregnancy; midwifery (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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