Birth Territory: A Theory for Midwifery Practice

Abstract

The theory of Birth Territory describes explains and predicts the relationships between the environment of the individual birth room, issues of power and control, and the way the woman experiences labour physiologically and emotionally.The theory was synthesised inductively from empirical data generated by the authors in their roles as midwives and researchers. It takes a critical post-structural feminist perspective and expands on some of the ideas of Michel Foucault. Theory synthesis was also informed by current research about the embodied self and the authors' scholarship in the fields of midwifery, human biology, sociology and psychology.In order to demonstrate the significance of the theory it is applied to two clinical stories that both occur in hospital but are otherwise different. This analysis supports the central proposition that when midwives use 'midwifery guardianship' to create and maintain the ideal Birth Territory then the woman is most likely to give birth naturally, be satisfied with the experience and adapt with ease in the post birth period. These benefits together with the reduction in medical interventions also benefit the baby. In addition, a positive Birth Territory is posited to have a broader impact on the woman's partner, family and society in general.

The motivation and capacity to go ‘above and beyond’: Qualitative analysis of free-text survey responses in the M@NGO randomised controlled trial of caseload midwifery

“…Therefore, lower levels of anxiety-pain may be associated with the clinical outcome that reported a higher proportion of women in the caseload group used no pharmacological analgesia during labour (OR 1.74, 95% CI 1.37-2.20; <0.0001) (Tracy et al, 2013). The Endorphic midwife is important not only in terms of maternal satisfaction but significant in terms of facilitating physiological birth (Buckley, 2015) by optimising psychophysiology (Fahy and Parratt, 2006).…”

Supporting women to achieve breastfeeding to six months postpartum – The theoretical foundations of a successful program

“…The theory of birth territory is about supporting women to draw from the deep, hidden capabilities within their embodied selves as they respond to childbearing challenges (44)(45)(46). For the purposes of the theory, birth refers to that period extending from peri-conception to early parenting.…”

“…Integrative power is the integration of all forms of power within the environment to achieve a shared goal (45,50). Integrative power aims to support a woman in responding spontaneously and expressively to her bodily sensations and intuitions (50).…”

“…The use of integrative power integrates her body, mind and spirit as a whole and results in optimised psychophysiological wellbeing (50). Providing a physically and emotionally safe environment is very important to enhance the use of integrative power (44). For instance, a woman who initiates breastfeeding in the birthing room needs a quiet and private place with minimum stimulation to enjoy the first moments with her child and her family.…”

“…In contrast, disintegrative power disintegrates the woman's inner power within the environment (44,45). It is an ego-centred power and anybody in the territory, including the woman, the midwife and the partner, can use disintegrative power (44).…”