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Sociology, Vol. 38, No. 1, 61-80 (2004)
DOI: 10.1177/0038038504039361

Practitioners’ Views about Equity within Prenatal Services

Priscilla Alderson

University of London

Clare Williams

King’s College London

Bobbie Farsides

King’s College London

The British National Health Service (NHS) is based on principles of equal access, treatment and outcomes.This article reviews health professionals’ aims to provide equitable prenatal services and their views on whether women could be equal in their access to services, understanding during choice-making, and satisfaction about their care. Inequalities which compromise equity, conflicting meanings of equity, and the contribution of in-hospital ethics seminars to ethical health services are considered. Qualitative research, combining sociological and philosophical methods, investigated the experiences of health care staff attempting to provide equitable services and their practical and ethical problems. A total of 70 staff at a teaching hospital and a district general hospital took part in semi-structured interviews, followed by 11 innovative in-hospital ethics seminars based on themes derived from the interviews.The 56 seminar participants usually began with clear statements of their equitable aims, but, encouraged by the health care ethicist, they went on to discuss their many concerns about obstacles which complicated the achievement of these aims. The sociological-ethics seminars provided unique opportunities for multi-disciplinary discussion of these inequalities and their impact on equitable intentions in health care. Analysis of the contradictions revealed during the seminars is guided by sociological theories that seek to explain the persistence of inequalities in health, and how NHS policies appear to perpetuate and increase them, despite practitioners’ stated intentions to promote equality.

Key Words: decision making • ethics • inequalities • prenatal screening


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