On the Margins of the Periphery: Unassisted Childbirth and the Management of Layered Stigma

Miller, April D.

doi:10.1080/02732173.2012.694795

Cited by 17 publications

(15 citation statements)

References 19 publications

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“…16,22 They became more cautious about whom they revealed their birthing decision to, as they learned that doing so would usually elicit negative responses from others. 15 This was especially the case in HICs like Norway, 15 Ireland, 16 and the United States, 22 where maternity care services were thought to be well developed and mothers were expected to give birth in hospitals. Even in parenting communities where home births were popular, parents almost always rely on professional midwives for care.…”

Section: Stigma From Parenting Communitiesmentioning

confidence: 99%

“…21 In comparison, there was a slight increase in freebirth rates observed in HICs such as the United States and the United Kingdom. 22,23 Greenfield and colleagues 24 suggested that the COVID-19 pandemic might have contributed to this increase. They explained that some women freebirthed as they feared contracting COVID-19 in hospitals and birth centers, whereas others chose to freebirth as local home birth services with midwives were suspended as a safety measure to prevent the spread of the virus.…”

Section: Differences Are Based On Geographical Locationsmentioning

confidence: 99%

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Trends and motivations for freebirth: A scoping review

Shorey

Jarašiūnaitė‐Fedosejeva

Akik

et al. 2023

Birth

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Background Even when maternity care facilities are available, some women will choose to give birth unassisted by a professional (freebirth). This became more apparent during the pandemic of coronavirus disease 2019 (COVID‐19), as women were increasingly concerned they would contract the virus in health care facilities. Several studies have identified the factors that influence women to seek alternative places of birth to hospitals, but research focusing specifically on freebirth is limited. Methods Eight databases were searched from their respective inception dates to April 2022 for studies related to freebirth. Data from the studies were charted and a thematic analysis was subsequently conducted. Results Four themes were identified based on findings from the 25 included studies: (1) Geographical and socio‐demographic determinants influencing freebirth, (2) Reasons for choosing freebirth, (3) Factors hindering freebirth, and (4) Preparation for and varied experiences of freebirth. Discussion More women chose to give birth unassisted in low‐ and middle‐income countries (LMICs) compared with high‐income countries (HICs). Overall, motivation for freebirth included previous negative birth experiences with health care professionals, a desire to adhere to their birth‐related beliefs, and fear of contracting the COVID‐19 virus. Included studies reported that study participants were often met with negative responses when they revealed that they were planning to freebirth. Most women in the included studies had positive freebirth experiences. Future research should explore the different motivators of freebirth present in LMICs or HICs to help inform effective policies that may improve birth experiences while maintaining safety.

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Section: Stigma From Parenting Communitiesmentioning

confidence: 99%

Section: Differences Are Based On Geographical Locationsmentioning

confidence: 99%

Trends and motivations for freebirth: A scoping review

Shorey

Jarašiūnaitė‐Fedosejeva

Akik

et al. 2023

Birth

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“…An increasing number of maternity care providers—particularly in high-income countries—encounter highly-educated and well-informed pregnant women who request less care than recommended by medical professionals [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. These women desire maternity care that is more in line with their personal ideas and preferences instead of merely sticking to what medical guidelines recommend [ 1 , 2 , 4 , 5 , 7 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

How to Make the Hospital an Option Again: Midwives’ and Obstetricians’ Experiences with a Designated Clinic for Women Who Request Different Care than Recommended in the Guidelines

Opdam¹,

Dillen

Vries

et al. 2021

IJERPH

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Background: An increasing number of maternity care providers encounter pregnant women who request less care than recommended. A designated outpatient clinic for women who request less care than recommended was set up in Nijmegen, the Netherlands. The clinic’s aim is to ensure that women make well-informed choices and arrive at a care plan that is acceptable to all parties. The aim of this study is to make the clinic’s approach explicit by examining care providers’ experiences who work with or within the clinic. Methods: qualitative analysis of in-depth interviews with Dutch midwives (n = 6) and obstetricians (n = 4) on their experiences with the outpatient clinic “Maternity Care Outside the Guidelines” in Nijmegen, the Netherlands. Results: Four main themes were identified: (1) ”Trusting mothers, childbirth and colleagues”; (2) “A supportive communication style”; (3) “Continuity of carer”; (4) “Willingness to reconsider responsibility and risk”. One overarching theme emerged from the data, which was “Guaranteeing women’s autonomy”. Mutual trust is a prerequisite for a constructive dialogue about birth plans and can be built and maintained more easily when there is continuity of carer during pregnancy and birth. Discussing birth plans at the clinic was believed to be successful because the care providers listen to women, take them seriously, show empathy and respect their right to refuse care. A change in vision on responsibility and risk is needed to overcome barriers such as providers’ fear of adverse outcomes. Taking a more flexible approach towards care outside the guidelines demands courage but is necessary to guarantee women’s autonomy. Key conclusions and implications for practice: In order to fulfil women’s needs and to prevent negative choices, care providers should care for women with trust, respect for autonomy, and provide freedom of choice and continuity. Care providers should reflect on and discuss why they are reluctant to support women’s wishes that go against their personal values. The structured approach used at this clinic could be helpful to maternity care providers in other contexts, to make them feel less vulnerable when working outside the guidelines.

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“…These are not the births to which I refer in talking about ‘solitary births.’ A woman who chooses to birth unassisted and expects no assistance or care from staff is not disappointed at the lack of assistance. The decision to birth unassisted (Chasteen Miller, 2009, 2012; Kaplan Shanley, 2012), however, is still marginal and uncommon. Chasteen Miller (2009) notices the influence of neoliberal ideals of ‘individualism’ and ‘freedom’ on some of the women choosing unassisted births, who consider a labor experienced completely on their terms and without help from others as the most empowering option (p. 53).…”

mentioning

confidence: 99%

We birth with others: Towards a Beauvoirian understanding of obstetric violence

Shabot

2020

European Journal of Women's Studies

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Obstetric violence – psychological and physical violence by medical staff towards women giving birth – has been described as structural violence, specifically as gender violence. Many women are affected by obstetric violence, with awful consequences. The phenomenon has so far been mainly investigated by the health and social sciences, yet fundamental theoretical and conceptual questions have gone unnoticed. Until now, the phenomenon of obstetric violence has been understood as one impeding autonomy and individual agency and control over the body. In this article I will argue that the phenomenon of obstetric violence occurs in a specific state of embodied vulnerability and that might be destructive for subjectivity since it fails to recognize that state and instead disallows support and demolishes relationships (among women and their lived-bodies; among women and their others) and interdependence. This might introduce a conceptual shift and the phenomenon might be reconceptualized as a moment where vulnerability is misrecognized and ambiguity, relations and support (rather than autonomy) are banned. In this case violence is recognized as cutting the original links to our bodies and the world that constitute our phenomenological condition, instead of as hurting the autonomous subject. Obstetric violence, thus, calls to be reflected upon through de Beauvoir’s ideas on ambiguity, the embodied and situated subject and the subject as essentially construed in relations. I believe that de Beauvoir’s conception of the authentic embodied subject as necessarily ambiguous – immanent and transcendent at the same time and ineludibly linked to the world and its others – will be extremely useful for construing this new understanding of how obstetric violence happens and of what precisely constitutes its damage.

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On the Margins of the Periphery: Unassisted Childbirth and the Management of Layered Stigma

Cited by 17 publications

References 19 publications

Trends and motivations for freebirth: A scoping review

Trends and motivations for freebirth: A scoping review

How to Make the Hospital an Option Again: Midwives’ and Obstetricians’ Experiences with a Designated Clinic for Women Who Request Different Care than Recommended in the Guidelines

We birth with others: Towards a Beauvoirian understanding of obstetric violence

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