Reflecting on practice to theorise empowerment for women: using Foucault's concepts.

The aim of this research is to understand how power operates in the medical encounter with the childbearing woman and to theorize ways in which midwives can empower women to experience control over what happens to them. Thirty-three Australian pregnant young women and the researcher participated in this study. A post-modern, feminist praxis approach was the research method used. Data was collected using participant observation, in-depth interviewing and reflective journaling. Data was analysed using Michel Foucault's theoretical concepts concerning disciplinary power/knowledge. Key theoretical findings are: knowing how power operates allows midwives to predict what will happen if the woman is intending to resist standardised medical birthing practices. When disciplinary medical power is used the purpose is to coerce patients to do what the doctor wants. Power and knowledge are inseparable, as each strengthens the other, thus Foucault writes of a single concept--Power/Knowledge. Medical power operates most effectively with the co-operation of the midwife and the submission of the childbearing woman. Medical power is normally invisible; it only becomes visible when resistance is encountered, whereupon rewards, threats and punishments are used in an attempt to gain submission. Women can be more empowered if the midwife shares knowledge, not just about pregnancy, labour and birth, but also about the woman's legal rights and what might happen if she decides to refuse standardised medical care. In this way women's empowerment can be facilitated so that they are more likely to experience the type of childbirth they desire.