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

Author

Listed:
  • 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)

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.

Suggested Citation

  • Eva Neely & Briony Raven & Lesley Dixon & Carol Bartle & Carmen Timu-Parata, 2020. "“Ashamed, Silent and Stuck in a System”—Applying a Structural Violence Lens to Midwives’ Stories on Social Disadvantage in Pregnancy," IJERPH, MDPI, vol. 17(24), pages 1-16, December.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:24:p:9355-:d:461944
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    References listed on IDEAS

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    1. Strulik, Holger, 2019. "Myopic Misery: Maternal Depression, Child Investments, And The Neurobiological Poverty Trap," Macroeconomic Dynamics, Cambridge University Press, vol. 23(2), pages 522-534, March.
    2. Lee, Jaewon & Seon, Jisuk, 2019. "Intergenerational transmission of maternal poverty to self-esteem among young adult children: The role of employment," Children and Youth Services Review, Elsevier, vol. 106(C).
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    Cited by:

    1. Gloria Macassa & Cormac McGrath & Mamunur Rashid & Joaquim Soares, 2021. "Structural Violence and Health-Related Outcomes in Europe: A Descriptive Systematic Review," IJERPH, MDPI, vol. 18(13), pages 1-14, June.
    2. Anna Matheson & Jacquie Kidd & Heather Came, 2021. "Women, Patriarchy and Health Inequalities: The Urgent Need to Reorient Our Systems," IJERPH, MDPI, vol. 18(9), pages 1-4, April.

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