Concurrent analysis of choice and control in childbirth

Austyn Snowden,Caroline Hollins Martin,Julie Jomeen,Colin Martin

doi:10.1186/1471-2393-11-40

Abstract

BackgroundThis paper reports original research on choice and control in childbirth. Eight women were interviewed as part of a wider investigation into locus of control in women with pre-labour rupture of membranes at term (PROM) [1].MethodsThe following study uses concurrent analysis to sample and analyse narrative aspects of relevant literature along with these interviews in order to synthesise a generalisable analysis of the pertinent issues. The original PROM study had found that women experienced a higher degree of control in hospital, a finding that appeared at odds with contemporary notions of choice. However, this paper contextualises this finding by presenting narratives that lucidly subscribe to the dominant discourse of hospital as the safest place to give birth, under the premise of assuring a live healthy baby irrespective of their management type.ResultsThis complex narrative is composed of the following themes: 'perceiving risk', 'being prepared', 'reflecting on experience', maintaining control' and relinquishing control'. These themes are constructed within and around the medical, foetocentric, risk averse cultural context. Primary data are presented throughout to show the origins and interconnected nature of these themes.ConclusionsWithin this context it is clear that there is a highly valued role for competent health professionals that respect, understand and are capable of facilitating genuine choice for women.

Highlights

This paper reports original research on choice and control in childbirth
Safety is a key issue in maternity care and despite the fact that childbirth has never been safer in the developed world, in terms of mortality, and the safety of labour and birth at home has been established [8], fear of birth amongst mothers remains [9,10]
Whilst this aim is not new, Concurrent analysis (CA) differs from recent approaches to qualitative synthesis [13,14,15] by integrating interview data gathered by the researcher

Summary

Introduction

This paper reports original research on choice and control in childbirth. Eight women were interviewed as part of a wider investigation into locus of control in women with pre-labour rupture of membranes at term (PROM) [1]. Current maternity policy [2,3] advocates choice and control for childbearing women equating these elements to both a better quality of experience and improved outcomes. Perceptions of risk, defined predominantly by medical experts, have mapped out what a ‘responsible’ decision should be and to question or ignore those definitions of risk is to be labelled a ‘bad mother’ [6]. This is lucidly illustrated by findings, which demonstrate that the majority of women, continue to cite hospital ‘as the best place to give birth’ and make choices [7]. Safety is a key issue in maternity care and despite the fact that childbirth has never been safer in the developed world, in terms of mortality, and the safety of labour and birth at home has been established [8], fear of birth amongst mothers remains [9,10]

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Conclusion