Doctors and Mothers
What type of doctors assist mothers during pregnancy?
Obstetricians are the primary doctors that play a role in maternal health care. "Obstetrics...is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy (prenatal period), childbirth and the postnatal period." [21]
The Doctor-Patient Relationship
During the time I spent researching at Ugandan hospitals, I was surprised at the lack of doctors I saw. There were usually only a few doctors present, whereas there were usually 10 to 20 midwives working at one time. The doctors were also less visible since they did not spend as much time with women in the clinics. They were usually in patient rooms and the surgical theatre. Overall, the doctor-patient relationship seemed weak or even non-existent. Furthermore, the women I spoke with were often displeased at the amount of time they spent waiting to see the doctor for a very short visit. It was difficult for the doctors to build close, personal relationships with these women when they were forced to see large numbers of women in one day. The shortage of doctors in Uganda may be negatively affecting the doctor-patient relationship by making doctors rush to see all of their patients. There are many other reasons that doctor-patient relationships are not as satisfying as many patients anticipate. Ellen Lazarus studied perinatal care and found that,
“Professionalization among resident physicians in my study led to a common perception of pregnancy and birth. As obstetricians-in-training they were learning to view the pregnant woman as a patient, and pregnancy and birth as a disease. Following the biomedical model, pregnancy and birth were treated as pathological or potentially pathological medical episodes and thus,, as other researchers have found, the residents in my study all believe that birth should be controlled by the medical profession through technological, pharamacological, and surgical means.” [22]
Another common issue with doctor-patient relationships is the power differentiation and status differences between the doctor and patient. The only Ugandan doctors I saw were all male. These gender differences between doctor and expectant mother could also make power differences even more pronounced. Lazarus discusses power in the doctor-patient relationship when she states,
“The doctor-patient relationship is asymmetrical, and power therefore becomes domination. This domination rests on the structural asymmetry of resources: who in the situation controls medical knowledge and technology. Unequal access to these resources necessarily implies a relationship in which one actor is more autonomous and the other more dependent. Following this line of reasoning, Taussig has demonstrated how disease symptoms, diagnostics, and medical therapeutics are controlled by the medical profession through professional domination of knowledge and technology, leaving patients with relatively little autonomy.” [23]
All of these issues with the doctor-patient relationship could create barriers to maternal health care for Ugandan women. From my experience, the women had more comfortable relationships with the midwives, which is discussed in the next section.
Obstetricians are the primary doctors that play a role in maternal health care. "Obstetrics...is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy (prenatal period), childbirth and the postnatal period." [21]
The Doctor-Patient Relationship
During the time I spent researching at Ugandan hospitals, I was surprised at the lack of doctors I saw. There were usually only a few doctors present, whereas there were usually 10 to 20 midwives working at one time. The doctors were also less visible since they did not spend as much time with women in the clinics. They were usually in patient rooms and the surgical theatre. Overall, the doctor-patient relationship seemed weak or even non-existent. Furthermore, the women I spoke with were often displeased at the amount of time they spent waiting to see the doctor for a very short visit. It was difficult for the doctors to build close, personal relationships with these women when they were forced to see large numbers of women in one day. The shortage of doctors in Uganda may be negatively affecting the doctor-patient relationship by making doctors rush to see all of their patients. There are many other reasons that doctor-patient relationships are not as satisfying as many patients anticipate. Ellen Lazarus studied perinatal care and found that,
“Professionalization among resident physicians in my study led to a common perception of pregnancy and birth. As obstetricians-in-training they were learning to view the pregnant woman as a patient, and pregnancy and birth as a disease. Following the biomedical model, pregnancy and birth were treated as pathological or potentially pathological medical episodes and thus,, as other researchers have found, the residents in my study all believe that birth should be controlled by the medical profession through technological, pharamacological, and surgical means.” [22]
Another common issue with doctor-patient relationships is the power differentiation and status differences between the doctor and patient. The only Ugandan doctors I saw were all male. These gender differences between doctor and expectant mother could also make power differences even more pronounced. Lazarus discusses power in the doctor-patient relationship when she states,
“The doctor-patient relationship is asymmetrical, and power therefore becomes domination. This domination rests on the structural asymmetry of resources: who in the situation controls medical knowledge and technology. Unequal access to these resources necessarily implies a relationship in which one actor is more autonomous and the other more dependent. Following this line of reasoning, Taussig has demonstrated how disease symptoms, diagnostics, and medical therapeutics are controlled by the medical profession through professional domination of knowledge and technology, leaving patients with relatively little autonomy.” [23]
All of these issues with the doctor-patient relationship could create barriers to maternal health care for Ugandan women. From my experience, the women had more comfortable relationships with the midwives, which is discussed in the next section.