A1 Journal article (refereed)
Kätilöiden eettinen toimijuus synnytyskulttuurin murroksessa (2024)
Midwives' ethical agency in the turning point of birth culture

Kaipainen, V., Kuurne, K., & Collin, K. (2024). Kätilöiden eettinen toimijuus synnytyskulttuurin murroksessa. Aikuiskasvatus, 44(2), 122-134. https://doi.org/10.33336/aik.137507

JYU authors or editors

Publication details

All authors or editors: Kaipainen, Vilma; Kuurne, Kaisa; Collin, Kaija

Journal or series: Aikuiskasvatus

ISSN: 0358-6197

eISSN: 2490-0427

Publication year: 2024

Publication date: 19/06/2024

Volume: 44

Issue number: 2

Pages range: 122-134

Publisher: Kansanvalistusseura

Publication country: Finland

Publication language: Finnish

DOI: https://doi.org/10.33336/aik.137507

Publication open access: Openly available

Publication channel open access: Open Access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/96278

Abstract

In Finland of the 2020s, childbirth has been politicised by birth-givers in parallel with the economic intensification of health care. This has increased the rush of obstetric professionals and put new pressures on required professional skills. We use narrative inquiry to examine what kinds of expressions of professional agency can be identified in midwives’ (N = 8) narratives on ethics in nursing, i.e., what and how midwives speak about the phenomenon we call ‘ethical agency’. The main concepts of the study are professional agency and nursing ethics, from which we construct the concept of ethical agency by integrating the nursing ethics perspective into professional agency. Through ’ethical agency’ we explore the problematics of agency positions and ethical care in obstetric care. The type narratives generated in the analysis show that the ethical agency of midwives is both limited and strong, depending on the situation. In relation to the system, ethical agency is often limited, as midwives are unable to impact busyness and increased workloads. According to midwives, the system limiting their ethical agency causes moral distress and a decrease in job satisfaction. However, midwives have considerable power in their relationship with the birth-givers, and ethical agency is strong but some-times ambiguous and ambivalent between the wishes of the birth-giver and the good of the child. The study results place the ethical problematic at the heart of professional agency and raise awareness of its topical issues, which require deeper understanding. ‘Ethical agency’ extends the concept of professional agency to ethical issues and provides a new conceptual opening for adult education research on work life.

Keywords: nursing ethics; nursing (work); midwives; professional identity; human agency; nursing sector; delivery (birth); narrative analysis

Free keywords: ethicality; human agency; ethical agency; moral agency; professional agency; moral distress

Contributing organizations

Ministry reporting: Yes

Reporting Year: 2024

Preliminary JUFO rating: 1