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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Why do some women choose to freebirth in the UK? An interpretative phenomenological study

Authors: Claire Feeley, Gill Thomson

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

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Abstract

Background

Freebirthing or unassisted birth is the active choice made by a woman to birth without a trained professional present, even where there is access to maternity provision. This is a radical childbirth choice, which has potential morbidity and mortality risks for mother and baby. While a number of studies have explored women’s freebirth experiences, there has been no research undertaken in the UK. The aim of this study was to explore and identify what influenced women’s decision to freebirth in a UK context.

Methods

An interpretive phenomenological approach was adopted. Advertisements were posted on freebirth websites, and ten women participated in the study by completing a narrative (n = 9) and/or taking part in an in-depth interview (n = 10). Data analysis was carried out using interpretative methods informed by Heidegger and Gadamer’s hermeneutic-phenomenological concepts.

Results

Three main themes emerged from the data. Contextualising herstory describes how the participants’ backgrounds (personal and/or childbirth related) influenced their decision making. Diverging paths of decision making provides more detailed insights into how and why women’s different backgrounds and experiences of childbirth and maternity care influenced their decision to freebirth. Converging path of decision making, outlines the commonalities in women’s narratives in terms of how they sought to validate their decision to freebirth, such as through self-directed research, enlisting the support of others and conceptualising risk.

Conclusion

The UK based midwifery philosophy of woman-centred care that tailors care to individual needs is not always carried out, leaving women to feel disillusioned, unsafe and opting out of any form of professionalised care for their births. Maternity services need to provide support for women who have experienced a previous traumatic birth. Midwives also need to help restore relationships with women, and co-create birth plans that enable women to be active agents in their birthing decisions even if they challenge normative practices. The fact that women choose to freebirth in order to create a calm, quiet birthing space that is free from clinical interruptions and that enhances the physiology of labour, should be a key consideration.
Literature
1.
2.
3.
Friedman S, Heneghan A, Rosenthal M. Characteristics of women who deny or conceal pregnancy. Psychosomatics. 2007;48:117–22.CrossRefPubMed
4.
Loughney A, Collis R, Dastgir S. Birth before arrival at delivery suite: Associations and consequences. Br J Midwifery. 2006;14(4):204–8.CrossRef
5.
6.
World Health Organization. Managing prolonged and obstructed labour. Geneva: WHO; 2008. p. 2.
7.
Duley L, Henderson-Smart D, Walker G, Chou D. Magnesium sulphate versus diazepam for eclampsia. The Cochrane Collaboration 2010. Accessed 4 Nov 2014.
8.
9.
10.
Lee A, Kozuki N, Belncowe H, Vos T, Bahalim A, Darmstadt G, et al. Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990. Paediatr Res. 2013;74(s1):50–72.CrossRef
11.
12.
King’s Fund. Safe Births: Everybody's business. 2008.
13.
Feeley C, Burns E, Adams E, Thomson G. Why do some women choose to freebirth? A meta-thematic synthesis, part one. Evid Based Midwifery. 2015;13(1):4–9.
14.
15.
Miller A. Midwife to Myself’: Birth Narratives among Women Choosing Unassisted Homebirth. Sociol Inq. 2009;79(1):51–74.CrossRef
16.
17.
Dahlen H, Jackson M, Stevens J. Homebirth, freebirth, and doulas: casualty and consequence of a broken maternity care system. Women Birth. 2011;24:47–50.CrossRefPubMed
18.
Cooper T, Clarke P. Home Alone. Midwives 2008; Jun/July RCM:34–38.
19.
Wickham S. Unassisted birth: listening and learning from the minority. Practising Midwife. 2008;11(6):4–5.PubMed
20.
Nolan M. Freebirthing: why on earth would women choose it? Practising Midwife. 2008;11(6):16–8.PubMed
21.
Edwards N, Kirkham M. Birthing without a midwife; a literature review. MIDIRS Midwifery Digest. 2013;23(1):7.
22.
23.
van Manen M. Phenomenology of Practice; Meaning-Giving Methods in Phenomenological Research and Writing. California: Left Coast Press Inc; 2014.
24.
25.
Bamberg M. Narrative Analysis. In: Cooper H, editor. APA handbook of research methods in psychology. Washington: APA Press; 2010. p. 1–39.
26.
Smith J, Flowers P, Larkin M. Interpretative Phenomenological Analysis. London: Sage; 2010.
27.
Regan P. Hans-Georg Gadamer’s philosophical hermeneutics: Concepts of reading, understanding and interpretation. Res Hermeneut Phenomenol Pract Philo. 2012;4(2):286–303.
28.
Laverty S. Hermeneutic phenomenology and phenomenology: a comparison of historical and methodological considerations. Int J Qualit Methods. 2003;2(3):1–29.
29.
30.
Lewis-Beck M, Bryman A, Futing Liao T, editors. The Sage Encyclopaedia of Social Science Research Methods: In vivo coding. Thousand Oaks: Sage Publications Inc; 2004.
31.
32.
Lavender T, Hofmeyr G, Neilson J, Kingdon C, Gyte G. Caesarean section for non-medical reasons at term. Cochrane Database of Syst Rev. 2006;3:CD004660.
33.
Keedle H, Schmeid V, Burns E, Dahlen H. Women’s reasons for, and experiences of, choosing a homebirth following a caesarean. BMC Pregnancy Childbirth. 2015;15:206.CrossRefPubMedPubMedCentral
34.
Bernhard C, Zielinski R, Ackerson K, English J. Home birth after hospital birth: women’s choices and reflections. J Midwifery Women’s Health. 2014;59(2):160–6.CrossRef
35.
Fenech G, Thomson G. Tormented by ghosts from their past’: A meta-synthesis to explore the psychosocial implications of a traumatic birth upon maternal well-being. Midwifery. 2014;30:185–93.CrossRefPubMed
36.
Ayers S, Joseph S, McKenzie-McHarg K, Slade P, Wijma K. Posttraumatic stress disorder following childbirth: Current issues and recommendations for research. J Psychom Obstetr Gynaecol. 2008;29(4):240–50.CrossRef
37.
Rapley T. Distributed decision making: the anatomy of decisions-in-action. Sociol Health Illness. 2008;30(3):429–44.CrossRef
38.
Coulter A, Parsons S, Askham J. Where are the patients in the decision making about their own care? Copenhagen: WHO Regional Office for Europe; 2008. p. 1.
39.
Smith S, Dixon A, Trevena L, Nutbeam D, McCaffery K. Exploring patient involvement in healthcare decision making across different educational and functional health literacy groups. Soc Sci Med. 2009;69(12):1805–12.CrossRefPubMed
40.
Nursing and Midwifery Council. Midwives Rules and Standards. 2012.
41.
Ball L, Curtis P, Kirkham M. Why do midwives leave? Talking to the managers. London: Royal College of Midwives; 2003. p. 1.
42.
DH. Maternity Matters. Choice, access and continuity of care in a safe service. 2007.
43.
Healthcare Commission. Towards Better Birth. 2008.
44.
Viisainen K. The moral dangers of homebirth: parents perception of risks in homebirth in Finland. Sociol Health Illness. 2000;6:792–814.CrossRef
45.
46.
Brocklehurst P, Hardy P, Hollowell J, Linsell L, Macfarlane A, Mccourt C, et al. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ. 2011;343:d7400.CrossRefPubMed
47.
NCT. An Investigation into Choice of Place of Birth. 2009.
48.
McCourt C, Rance S, Rayment J, Sandall J. Birthplace qualitative organisations case studies: How maternity care systems may affect the provision of care in different birth settings. Birthplace in England research programme. Final Report Part 6. Southampton: NIHR Service Delivery and Organisation programme; 2011.
49.
RCM. Survey of current midwives thinking of homebirth. 2011.
50.
Renfrew M, Homer C, Downe, S, McFadden, A, Muir N, Prentice T, ten Hoope-Bender P. Midwifery, An Executive Summary to The Lancet’s Series. 2014.
51.
Benoit C et al. Understanding the social organisation of maternity care systems: midwifery as a touchstone. Sociol Health Illness. 2005;27(6):722–37.CrossRef
52.
Walsh D. Risk and Normality in Maternity Care: Revisioning Risk for Normal Childbirth. In: Symon A, editor. Risk and Choice in Maternity Care: An international perspective. Philadelphia: Elsevier; 2006. p. 89–100.
Metadata
Title
Why do some women choose to freebirth in the UK? An interpretative phenomenological study
Authors
Claire Feeley
Gill Thomson
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0847-6

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