Sensitivity as epistemology: the role of sensitivity in midwifery care in Newfoundland and Labrador

Abstract

Research shows that midwifery care is more positive for birthing parents and their babies than biomedical birth care, leading to fewer medical interventions and more highly rated client experiences. In this thesis I argue that midwifery care in Newfoundland and Labrador (NL) treats sensitivity and embodied knowledge as a valid epistemological approach to care. By respecting the sensitivity of clients and their own understanding and awareness of their bodies, midwives provide their clients with a high quality of care. Sensitivity is defined here as being attuned to other peoples’ needs, and prioritizing emotions, agency, and empathy. Midwives engage in ‘deep acting’ to provide sensitive care to their clients, which is reflected both in historical accounts of midwifery in NL, and in recent interviews conducted for this thesis. Sensitivity as the driving concept in this analysis centres voices and ways of knowing often excluded from epistemic authority, while questioning the institutionalization and medicalization of birth. Through narrative analysis of semi-structured interviews with ten midwifery clients in NL, four main themes emerged: Continuity of Care; Advocacy & Agency; Relationships; and Sensitivity & Emotions. These interviews share the significance of midwifery clients’ stories and demonstrate that their embodied knowledge is essential to gaining a wholistic understanding of sensitivity in midwifery care.