"I Delivered With a Team Where I Recognized No One": Understanding Depersonalization of Healthcare Through Women's Birth Stories.

Abstract

The COVID-19 pandemic brought significant changes to obstetric care, leading to decreased interactions, heightened medical interventions, and restricted support for birthing individuals, which in turn increased the risk of maternal and infant health concerns. This study investigated how birth stories from individuals who gave birth during the pandemic reflected their relational orientation toward healthcare providers, using Martin Buber's I-It and I-Thou framework and Davis-Floyd's technocratic model of birth as analytical lenses. Based on a phronetic iterative approach, data were gathered at three time points from surveys, focus groups, and interviews with 50 participants. Results revealed that birth narratives often reflected an I-It orientation, with healthcare providers described impersonally as a collective "they." Experiences were characterized by strict protocols, information control, and isolation, forming the mechanized birth. In contrast, stories involving meaningful interpersonal connections with healthcare providers illustrated the preservation of a "normal" birth experience and revealed the dialogical nature of birth and I-Thou orientation, in which relational, humanized care emerged despite pandemic restrictions. Findings emphasize the need for relationship-centered care that prioritizes patient individuality, humanity, and rights, even in times of crisis. Healthcare providers and policymakers should consider balancing technological efficiency with holistic, humanistic medicine, and consider how post-pandemic obstetric care can incorporate philosophical and ethical principles that prioritize relational aspects of birth for improved maternal and infant outcomes.