Journal Article•
The business of being born.
TL;DR: This compelling exposé takes a hard look at America's maternity care system, juxtaposing hospital deliveries against the growing popularity of at-home, natural childbirths that some expectant parents are opting for.
Abstract: 2008 84 minutes Director Abby Epstein's controversial documentary takes a hard look at America's maternity care system, juxtaposing hospital deliveries against the growing popularity of at-home, natural childbirths that some expectant parents are opting for. Former talk show host Ricki Lake was inspired to produce this compelling exposé after a dissatisfying birthing experience with her first child left her with many unanswered questions.
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TL;DR: A survey of the literature on motherhood and mothering can be found in this paper, where the authors argue that academic feminism has marginalized and neglected both mothers as mothers and the study of motherhood more generally.
Abstract: This article surveys scholarship on motherhood and mothering published over the past decade. Academic scholars and writer-activists have written about mothers and mothering in a diversity of genres and a with broad range of disciplinary and theoretical approaches. Work on motherhood is wide-ranging and fragmented, but taken as a whole, this work simultaneously insists on the particularity and specificity of motherhood while at the same time rejecting any notion of a fixed or essential aspect of maternal experience, desire, or subjectivity. The article argues that academic feminism has marginalized and neglected both mothers as mothers and the study of motherhood more generally. This essay endeavors to bring this literature to the attention of academic feminists and to argue for the necessity of including motherhood in a broader feminist movement.
98 citations
Dissertation•
01 Aug 2018
TL;DR: In this article, a new philosophy of birth space design is proposed that values the diverse spatial practices and space-based experiences of childbearing women, across all types of birth venues and experiences of birth.
Abstract: This thesis proposes a new philosophy of birth space design that values the diverse spatial practices and space-based experiences of childbearing women, across all types of birth venues and experiences of birth. The research aligns with the philosophy of woman-centred maternity care. It critically examines this as an intervention imposed on to a pre-existing medical system of care - a system which, in turn, influences the techno-rational basis of healthcare evidence-based architecture and the tendency for researchers to investigate the birth environment in quantifiable ways. The thesis proposes that birth space should be interrogated in a number of new qualitative ways: by user experience-based spatial design starting with the interiors of buildings; by examining women’s patterns of use of space over time, especially in relation to social interactions; and by interpreting space-based experiences within women’s birth stories. The literature review draws from a wide-range of literature: architectural, spatial, birth-environment, social theory, midwifery, obstetrics and policy documents. It critiques the naive readings of homely, control, safety and risk, and architecture understood as a techno-rational domain, in the extant research relating to birth spaces.
This thesis has an interpretative methodology that crosses disciplinary boundaries, and the definitions of architectural space and childbirth, that have previously limited knowledge of birth spaces. The nature of what is appropriate evidence for design, the spatial understanding afforded by using visual qualitative methods, semiotic meaning within policy documents, the nature of personal experiences of childbirth, and the application of a critical spatial methodology to birth spaces, all inform the selection of methods.
Representations of architecture are used to interpret the social and spatial meaning that architecture represents to birth space producers and users. Spatial practices for producing birth spaces are interpreted from the three policy design guidance documents commonly used in the context of maternity care in the UK; and the spatial practices of childbearing women are interpreted from the experiences of twenty-four women who took part in qualitative interviews. The transcripts, policy guidance documents and drawings were thematically-analysed and the visual data was also examined as semiotic materials.
The findings demonstrate that birth spaces are prosumed and curated by women. Birth space is experienced as a socially-situated progression through time - and not contained within one room as current guidance implies. Women’s spatial experiences are embodied and influenced by prior experience and expectations of birth venues. Space is experienced in multiple ways (visually, via perceived affordances, and via movement) that are contingent on the venue. Experiences of waiting and of labour as a ‘physical journey’ are both spatially significant. Women want to use spatial strategies to self-manage the ebb and flow of companionship in labour. Women build personally-meaningful intergenerational stories from where birth took place.
The discussion chapter develops spatial insights into the design guidance and maternity policy goals (choice, control, continuity of carer and personalised care) from the interpretation of women’s experiences. The thesis creates a new critical understanding of the value of social architecture for improving midwifery practice and women’s birth experiences. Practical recommendations to be applied to existing maternity spaces are proposed. Existing spatial and social theory is applied to the new area of birth space, and its lacunae identified. The thesis concludes with a new situated spatial theory derived from women’s experiences of childbirth as inspiration for much needed further interdisciplinary research and design development in this area.
42 citations
TL;DR: Six main categories emerged from the data, including feeling independent, strong and confident, doing it my way, protection from hospital related activities, having a safety net, selective listening and telling, and engaging support; the core category was having faith in normal.
Abstract: Objective to explore the influences on women who chose a publicly-funded home birth in one Australian state. Design a constructivist grounded theory methodology was used. Setting a publicly-funded home birth service located within a tertiary referral hospital in the southern suburbs of Sydney, Australia. Participants data were collected though semi-structured interviews of 17 women who chose to have a publicly-funded home birth. Findings six main categories emerged from the data. These were feeling independent, strong and confident, doing it my way, protection from hospital related activities, having a safety net, selective listening and telling, and engaging support. The core category was having faith in normal. This linked all the categories and was an overriding attitude towards themselves as women and the process of childbirth. The basic social process was validating the decision to have a home birth. Conclusion women reported similar influences to other studies when choosing home birth. However, the women in this study were reassured by the publicly-funded system׳s ‘safety net' and apparent seamless links with the hospital system. The flexibility of the service to permit women to change their minds to give birth in hospital, and essentially choose their birthplace at any time during pregnancy or labour was also appreciated. Implications for practice women that choose a publicly-funded home birth service describe strong influences that led them to home birth within this model of care. Service managers and health professionals need to acknowledge the importance of place of birth choice for women.
36 citations
01 Jan 2014
TL;DR: The authors conducted a qualitative study of 22 contemporary black certified midwives, certified nurse-midwives and certified professional midwives to understand how a very racist and classist denigration of black midwives in the early 20 th century is still manifesting itself in their experiences and perceptions of predominantly white midwifery education programs and professional organizations.
Abstract: Within the last decade, historical and contemporary accounts of midwives, along with the efficacy of the Midwives Model of Care for pregnancy, childbirth and general women's health, have become increasingly popular in mainstream publications and documentaries. Yet, very few of these accounts represent black midwives despite a long history of midwifery in the black community. This qualitative study of 22 contemporary black Certified Midwives, Certified Nurse-Midwives and Certified Professional Midwives, of varying ages, years of experience and U.S. region, seeks to understand how a very racist and classist denigration of black midwives in the early 20 th century is still manifesting itself in their experiences and perceptions of predominantly white midwifery education programs and professional organizations. I frame the reported experiences of institutionalized racism as " the contemporary midwife problem " and explore the social operation of racism and its impact on poor black birth outcomes, as well as relevant federal and local policy implications.
34 citations
TL;DR: The struggle for contested boundaries is entering a new phase as maternity care professionals struggle with different perceptions of what multidisciplinary collaboration means in the delivery of primary maternity care.
Abstract: Background the maternity services reforms announced by the Australian government herald a process of major change. The primary maternity care reforms requires maternity care professionals to work collaboratively as equals in contrast to the current system which is characterised by unequal relationships. Aim critical discourse analysis (CDA) using neoliberalism as an interpretive lens was employed to determine the positions of the respective maternity care professionals on the proposed reform and what purpose was served by their representations to the national review of maternity services. Method a CDA framework informed by Fairclough, linking textual and sociological analysis in a way that foregrounds issues of power and resistance, was undertaken. Data were collected from selected written submissions to the 2008 national review of maternity services representing the position of midwifery, obstetrics, general practitioners including rural doctors and maternity service managers. Findings maternity care professionals yielded several discourses that were specific to the discipline with a number that were shared across disciplines. The rise in consumerism has changed historical positions of influence in maternity services policy. The once powerful obstetric position in determining the direction of policy has come under siege, isolated in the presence of a powerful alliance involving consumers, midwives, sympathetic maternity service managers and some medical professions. The midwifery voice has been heard, a historical first, supported by its presence as a member of the alliance. Conclusion the struggle for contested boundaries is entering a new phase as maternity care professionals struggle with different perceptions of what multidisciplinary collaboration means in the delivery of primary maternity care.
31 citations