The best laid plans? Women’s choices, expectations and experiences in childbirth

Abstract

The past decades have seen a drastic increase in the medicalization of childbirth, evidenced by increasing Caesarean section rates in many Western countries. In a rare moment of congruence, alternative health-care providers, feminist advocates for women's health and, most recently, mainstream medical service providers have all expressed serious concerns about the rise in Caesarean section rates and women's roles in medicalization. These concerns stem from divergent philosophical positions as well as differing assumptions about the causes for increasing medicalization. Drawing on this debate, and using a feminist and governmentality framing of the problem, we interviewed 22 women who have recently had children about their birthing choices, their expectations and their birth experiences. The women's narratives revealed a disjuncture between their expectations of choosing, planning and achieving as natural a birth as possible, and their lived experiences of births that did not typically go to plan. They also reveal the disciplining qualities of both natural and medical discourses about birth and choice. Furthermore, their narratives counter assumptions that women, as ideal patient consumers, are driving medicalization.

Media Representations of Breech Birth: A Prospective Analysis of Web‐Based News Reports

“…[38][39][40] The medical system's influence on social discourse is demonstrated in much of the literature studying media's treatment of birth in general, as well as choices for other modes of birth such as vaginal birth after cesarean. [41][42][43][44] It appears the news reports investigated in this study have been influenced by the medical system's uptake of the findings of the Term Breech Trial, where cesarean births are largely seen as the default management for breechpresenting fetuses, and the risks associated with vaginal breech birth are perceived to be higher than current evidence suggests. 11 The lack of detail regarding medical malpractice suits associated with vaginal breech birth demonstrate that the news reports examined in this study tended to focus on poor outcomes related to vaginal breech birth without deeper investigation of the possible causes of the adverse events.…”

Empowering women through the positive birth movement

“…Within a Western culture there is not always a straightforward relationship between women's expectations of and their lived experience of birth. Malacrida and Boulton (2014) argue that women's experiences of pregnancy and birth are shaped by three dominant positions -medical, natural birth advocacy and feminist.…”

“…The natural birth advocacy movement stresses the woman's natural capacity for birth and an intervention free home birth is considered to be the gold standard (Cheyney, 2008). Women are encouraged to use methods such as hypnotherapy and write birth plans, which outline the levels of medical involvement considered to be acceptable, to maximise their chances of an intervention free birth (Malacrida & Boulton, 2014).…”

An integrative literature review on midwives' perceptions on the facilitators and barriers of physiological birth

“…Labour and childbirth are normal physiological processes (Canadian Association of Midwives, January 2010). However, the advancement in technology as well as an increasing domination of obstetrician-led childbirths has resulted in the medicalisation of childbirth (Malacrida & Boulton, 2014). Although the use of technology has generally lowered maternal and foetal mortality rates during labour and delivery (Wall et al, 2010), women are subjected to more unnecessary interventions (Scamell & Alaszewski, 2012), and, ironically, subsequent risks are brought to both mother and foetus (Buckley, 2015).…”