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Health research suggests that personal agency plays a key role in health experiences. In this qualitative analysis of the experiences of 40 recent mothers accessing healthcare services from physicians and midwives, we found that agency is linked to democratic relationships that support women's access to and discussion of relevant health information. While most participants wanted to participate more actively in their care, problematic physician-patient communication hampered their ability to exercise personal agency. This was not true for midwives who have a model of practice that emphasizes education and choice. Different understandings of embodiment affect the development of health care relationships.

KEY WORDS: Pregnancy, midwives, personal agency, social determinants of health, physician-patient communication, qualitative health research, health care relationships.


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Rory Coughlan, Department of Psychology, Trent University,

Ontario, Canada

Karen E. Jung, University of Victoria, British Columbia, Canada

Acknowledgements: The research on which this article is based received generous support in the form of a SSHRC Fellowship and a Dr. Julius Schleicher Fellowship for Research in Medicine.

All correspondence to be sent to: Dr. Rory Coughlan, Assistant Professor of Health Psychology, Department of Psychology, Trent University, 1600 West Bank Drive, Peterborough, ON, K9J 7B8, Canada. Phone: 1-705-748-1011 ext. 1079. Fax: 1-705-7481580. Email:

Karen E. Jung, Department of Sociology, University of Victoria, Mailing Address: 450 Weller Street, Peterborough, ON, K9H 2N6, Canada. Phone: 1-705-745-6526. Email:

JOURNAL OF PRENATAL AND PERINATAL PSYCHOLOGY AND HEALTH publishes research and clinical articles from the cutting edge of the science of prenatal and perinatal psychology and health. The journal, published quarterly since 1986, is dedicated to the in-depth exploration human reproduction and pregnancy and the mental and emotional development of the unborn and newborn child.

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