Intuition as Authoritative Knowledge in Midwifery and Homebirth

Abstract

As defined by Jordan (1992, 1993[1978]), authoritative knowledge motivates decision and action. Based on interviews with 22 white middle-class midwives in the United States conducted between 1992 and 1993, this article explores the inner knowing that constitutes a primary source of authoritative knowledge for homebirthers but is granted no authority in the realm of technomedicine. The purpose of this article is to call attention to these midwives' utilization of and reliance on intuition as a guide to action and decision making during homebirths. The midwife-interviewees are highly literate and competent in technological skills and biomedical diagnosis, and are keenly aware of the cultural and legal risks they run when they cannot justify their actions during a birth in logical, rational terms. Nevertheless, the deep value they place on connection, in the context of their holistic model of birth and health care, leads them to listen to and follow their "inner voice" during birth, rather than operating only according to protocols and standard parameters for "normal birth". The nature of intuition and the reasons for and consequences of the general devaluation of intuitive thinking by the wider society are also considered.

Informing Evidence: Claimsmaking in Midwives’ and Clients’ Talk About Interventions

“…The ideal posits women as inherently capable of giving birth without high-tech hospital surveillance (p. 236). Emotional, intuitive, spiritual, narrative, and other ways of knowing (James, 1997, p. 184) are therefore both legitimate and welcome (Cheyney, 2008;Davis-Floyd & Davis, 1996). Brigitte Jordan (1997) contended, however, that biomedical knowledge has become the authoritative knowledge in North American pregnancy care.…”

“…Brigitte Jordan (1997) contended, however, that biomedical knowledge has become the authoritative knowledge in North American pregnancy care. Jordan and others (see Davis-Floyd & Davis, 1996;Davis-Floyd & Sargent, 1997;Lay, 2000;Spoel, 2004;Stewart, 2001) suggested that biomedical authoritative knowledge underlies a representation of pregnancy as risky, which serves to enhance the authority of physicians over women and over midwives. Annandale (1988) argued that women's expectations of birth are "never fully independent of obstetrical notions of risk" (p. 99).…”

Place of Birth and Concepts of Wellbeing

“…Some work in this area has focused on midwives rather than women (Hunter 2002, Rayment 2011 and explored the effects on midwives of working in different settings (Hunter and Deery 2009;Hunter 2003;Ledward 1996;Sandall 1996). Shaw and Kitzinger (2005) and Davis-Floyd and Davis (1996) are among a number of writers who have suggested that women feel more in control of their birth at home or in home-like settings such as free-standing birth centres. One reason given for this feeling of control is that the woman has the higher status of 'resident' at home and the midwife is constructed as a 'visitor', whereas in hospital these roles are reversed (Halford and Leonard 2003).…”

Standards and Stories: The Interactional Work of Informed Choice in Ontario Midwifery Care

“…In Ontario, the first province to regulate midwifery as a primary care profession (Ontario Midwifery Act 1991), the College of Midwives (1994Midwives ( /2005 defines informed choice as involving "a co-operative and collaborative information exchange between the midwife and the woman" that supports "the woman as primary decision-maker." Consonant with its roots in the alternative childbirth and women' s health movements of the 1970s, this model explicitly values the exchange of diverse forms of evidence, including emotional, intuitive, spiritual and narrative ways of knowing along with more biomedical and scientific modes (Davis-Floyd and Davis 1996;James 1997;MacDonald 2006).…”