Bringing women's birth stories to light : a narrative study.

Abstract

This qualitative study explored women's childbirth narratives. The purpose of this research was to reveal women's experiences of birth and the meanings they interpret from their birth stories. Through a narrative methodology, this study intended to be the first locally in giving women a voice to construct their birth experiences and generate a contextualised interpretation of birth in the local setting. This research was located in the critical theory paradigm and framed by a feminist perspective. Ten narratives were generated through twenty interviews; two interviews were conducted with each woman. The narratives were analysed through dialogical analysis of the narratives. Four major conceptual inferences were generated: 'The Medicalisation of childbirth', 'Women's critique of assistance during birth', 'Normalising discourses' and 'Women in labour: Performing birth and transforming the self. These indicated that medicalisation was prevalent in women's local experiences of birth. This was associated to an emphasis on pathology, risk, technology and medical interventions. Assistance during birth, especially from the medical institution, was often authoritative and paternalistic. However, some women also experienced supportive and individualised care, primarily from midwives. Women considered birth to be a normal or natural process. Normalising discourses of birth reinforced this conception but though constructed to resist medicalisation, these discourses could suggest an essentialist representation of women and birth. For women birth represented a unique, personal and holistic experience, which instigated a meaningful transformation of the self and signified the naissance of maternal identity. This study recommends that the practice of childbirth needs to be grounded in the principles of individualised, holistic and supportive midwifery-led care. Current intrapartum practice also needs to decrease medicalisation, develop information giving and informed consent and promote the practice of normal birth. Women need to be empowered and birthgiving must be considered as a creative and individual performance, which is informed by women's own subjective, experiential and situated knowledge.