Here is a post on Amy Romano's blog, Science and Sensibility: Are Consumers at the bottom of the evidence pyramid?
To sum it up: research is being done to find evidence of care in what we (medical/nursing people) do to the consumer, and not what involves consumer (patient/family) participation. Studies are done on perfecting surgical techniques, medications given, things of that nature, but studies are rarely done about what women/families do to help themselves or each other during labor, birth, postpartum and neonatal care.
I feel incredibly frustrated, as the health care provider towards the very end of a woman's pregnancy. I cannot, as the labor and delivery nurse, do a whole lot to educate women about their choices and how to empower themselves during their pregnancy. Women come to me on the L&D unit when they are in labor, have complications, or are being induced for labor. Yes, I do a whole lot of teaching about the labor process, pain management, coping/alternatives to pain medication or epidurals, the induction process, medical conditions, medical treatment and interventions. But it's almost like shutting the barn door after the animals have escaped. I am at the tail end of a woman's pregnancy. She has had nine months for education and empowerment -- but has she received it? Is it adequate enough for her to make informed decisions about her body and her newborn baby?
I am very excited though, as a midwifery student, about the possibility of being able to enact change. I'm excited about how I can help reach women in new ways to help them with their self-care, education, and their spiritual and physical pathways to becoming mothers.
(Side note: if you are interested in midwifery and the medical profession -- where it has been, where it is now, where it is going -- go read Midwifery and Childbirth in America by Judith Pence-Rooks.)