Mariamni Plested1, Mavis Kirkham2. 1. Graduate School [Interdisciplinary Faculties of Philosophy and Nursing], Marquette University, 1250 Wisconsin Avenue, Milwaukee, WI 53233, USA. Electronic address: mariamni.plested@marquette.edu. 2. Graduate School [Interdisciplinary Faculties of Philosophy and Nursing], Marquette University, 1250 Wisconsin Avenue, Milwaukee, WI 53233, USA. Electronic address: maviskirkham@hotmail.com.
Abstract
PURPOSE: the broad aim of this study was to examine the lived-experience of women who birth without a midwife or other health-care professional in the United Kingdom; the specific purpose of this paper is to examine risk discourse as experienced by these women. RESEARCH DESIGN: reflective lifeworld research, a phenomenological approach was used in this study based on the philosophical writings of Husserl, Merleau-Ponty and Gadamer (Dahlberg et al., 2008). 10 in-depth interviews were conducted with women who had birthed without a midwife or other health-care professional present, interviews were transcribed and hermeneutically analysed. FINDINGS: women׳s lived-experiences of the maternity services in this study suggest a pervading mood of fear which finds voice in manipulative risk discourse and midwifery behaviours that can result in women avoiding maternity care. Fear based ׳risk-talk׳ is used as a scare tactic to coerce women into particular choices; if women do not comply they are labelled ׳risk-takers׳ and can become ostracised by the maternity care system. KEY CONCLUSIONS: risk discourse and its emphasis on mortality and morbidity raises awareness of death and creates important existential concerns for women which are unaddressed by health-care professionals. This can lead to a loss of trust in health-care professionals and women sourcing positive support and a salutogenic approach to childbirth from outside the system. IMPLICATIONS FOR PRACTICE: health-care professionals need to become aware of and address manipulative and coercive attitudes in risk discourse.
PURPOSE: the broad aim of this study was to examine the lived-experience of women who birth without a midwife or other health-care professional in the United Kingdom; the specific purpose of this paper is to examine risk discourse as experienced by these women. RESEARCH DESIGN: reflective lifeworld research, a phenomenological approach was used in this study based on the philosophical writings of Husserl, Merleau-Ponty and Gadamer (Dahlberg et al., 2008). 10 in-depth interviews were conducted with women who had birthed without a midwife or other health-care professional present, interviews were transcribed and hermeneutically analysed. FINDINGS:women׳s lived-experiences of the maternity services in this study suggest a pervading mood of fear which finds voice in manipulative risk discourse and midwifery behaviours that can result in women avoiding maternity care. Fear based ׳risk-talk׳ is used as a scare tactic to coerce women into particular choices; if women do not comply they are labelled ׳risk-takers׳ and can become ostracised by the maternity care system. KEY CONCLUSIONS: risk discourse and its emphasis on mortality and morbidity raises awareness of death and creates important existential concerns for women which are unaddressed by health-care professionals. This can lead to a loss of trust in health-care professionals and women sourcing positive support and a salutogenic approach to childbirth from outside the system. IMPLICATIONS FOR PRACTICE: health-care professionals need to become aware of and address manipulative and coercive attitudes in risk discourse.