A feminist critique of foundational nursing research and theory on transition to motherhood

Question: is using 'transition to motherhood theory' the best way to guide midwives in providing woman-centred care? Background: contemporary research about changes to women's embodied sense of self during childbearing is influenced by foundational research and theory about the transition to motherhood. Rubin and Mercer are two key nursing authors whose work on transition to motherhood theory still shapes the ways in which a woman's experience of change during childbearing is understood in midwifery. Methods: using a feminist post-structural framework, Rubin and Mercer's theory and research is described, critiqued and discussed. Findings: Rubin and Mercer used pre-existing theories and concepts that had the effect of finding similarities and discarding differences between women. Rubin and Mercer's theory and research is an expression of humanistic philosophy. This philosophy creates frameworks that have an assumed, disempowered role for childbearing women. Their research used a logico-empirical, quantitative approach. Qualitative interpretive or constructivist approaches offer more appropriate ways to study the highly individualised, embodied, lived experience of a woman's changing self during childbearing. Conclusion: Rubin and Mercer's theory is baby-centred. Transition to motherhood theory privileges the position of experts in directing how a woman should become a mother. This has the effect of making midwives agents for the social control of women. Implications for practice: Rubin and Mercer's transition to motherhood theory is a well-intentioned product of its time. The theory is inconsistent with contemporary midwifery philosophy which promotes a woman-centred partnership between the midwife and the woman. The usefulness of this outdated nursing theory in midwifery teaching, research or practice is debatable. (C) 2010 Elsevier Ltd. All rights reserved.