Designing out the Fear Cascade to increase the likelihood of normal birth

Abstract

Increasing normal birth by lowering the rate of birth by caesarean section (CS) has become high on the list of health priorities for professional and government bodies in much of the developed world (Maternity Care Working Party, 2007; Society of Obstetricians and Gynaecologists of Canada (SOGC) et al., 2008; Commonwealth of Australia, 2009; American College of NurseMidwives et al., 2012). Researchers have explored many strategies for addressing the rising rate of CS (Bugg et al., 2011; Hatem et al., 2008; Hodnett et al., 2012; Jones et al., 2012; Smyth et al., 2013). However few of the strategies are informed by a theoretical understanding of women's psycho-emotional experience of institutional based intrapartum care and the ebb and flow of emotional needs during labour as it progresses towards birth. In particular, few consider the woman's inherent, mammalian need to feel safe and secure in the space in which she has chosen to give birth (Naaktgeboren, 1989; Buckley, 2004). This paper aims to address this gap by extending current understandings of the theory of birth territory (Fahy, 2008; Fahy et al., 2011). It does this by applying Binding (Stenglin, 2004, 2007), a theoretical tool drawn from social semiotics which reveals how spaces can be designed to