Tensions and conflicts in ‘choice’: Womens’ experiences of freebirthing in the UK

Feeley, Claire; Thomson, Gill

doi:10.1016/j.midw.2016.07.014

Cited by 29 publications

(25 citation statements)

References 30 publications

(1 reference statement)

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“…Shared decision making (SDM) and true autonomy within consultations between clients and health care professionals are problematic ( Barry & Edgman-Levitan, 2012 ; Elwyn et al, 2012 ; Holten & de Miranda, 2016 ; Stiggelbout et al, 2012 ). Conflict arises around the negotiation of a birth plan ( Chervenak & McCullough, 2017 ; DeBaets, 2017 ; Feeley & Thomson, 2016 ; Hollander et al, 2016 ). Conflict in negotiation can also lead to a search for more tailored care ( Hollander, de Miranda et al, 2017 ; Schoot, Proot, ter Meulen, & de Witte, 2005 ).…”

Section: Methodsmentioning

confidence: 99%

“…Defining moments in the decision to seek holistic (outside the system) care often lie in conflict or previous trauma ( Feeley & Thomson, 2016 ; Hollander, de Miranda et al, 2017 ; Kotaska, 2017 ). As a rival proposition, the researchers explored whether the choice to birth outside the system was a positive first choice rather than the result of conflict or previous trauma, as this was one of the themes in Holten and de Miranda’s (2016) scoping review.…”

Section: Methodsmentioning

confidence: 99%

“… Feeley and Thomson (2016) in a study on freebirth (or UC) in the United Kingdom found that women who chose UC faced opposition and conflict from maternity providers. The authors found that conflict appeared to be an important factor in the choice to birth outside the system.…”

Section: Introductionmentioning

confidence: 99%

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When the Hospital Is No Longer an Option: A Multiple Case Study of Defining Moments for Women Choosing Home Birth in High-Risk Pregnancies in The Netherlands

2018

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Some women in a high-risk pregnancy go against medical advice and choose to birth at home with a “holistic” midwife. In this exploratory multiple case study, grounded theory and triangulation were employed to examine 10 cases. The women, their partners, and (regular and holistic) health care professionals were interviewed in an attempt to determine whether there was a pattern to their experiences. Two propositions emerged. The dominant one was a trajectory of trauma, self-education, concern about paternalism, and conflict leading to a negative choice for holistic care. The rival proposition was a path of trust and positive choice for holistic care without conflict. We discuss these two propositions and make suggestions for professionals for building a trusting relationship using continuity of care, true shared decision making, and an alternative risk discourse to achieve the goal of making women perceive the hospital as safe again.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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When the Hospital Is No Longer an Option: A Multiple Case Study of Defining Moments for Women Choosing Home Birth in High-Risk Pregnancies in The Netherlands

2018

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“…However, our findings suggest that the midwives perceived this to be unusual practice in relation to their peers which may be reflective of their 'willingness' to engage with women making these choices [33]. Moreover, findings from studies about women's perspectives [32,73,74], and a recent legal challenge [75], suggest that not all maternity professionals are offering full information based upon women's wants/needs.…”

Section: Plos Onementioning

confidence: 80%

Understanding how midwives employed by the National Health Service facilitate women’s alternative birthing choices: Findings from a feminist pragmatist study

2020

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UK legislation and government policy favour women’s rights to bodily autonomy and active involvement in childbirth decision-making including the right to decline recommendations of care/treatment. However, evidence suggests that both women and maternity professionals can face challenges enacting decisions outside of sociocultural norms. This study explored how NHS midwives facilitated women’s alternative physiological birthing choices–defined in this study as ‘birth choices that go outside of local/national maternity guidelines or when women decline recommended treatment of care, in the pursuit of a physiological birth’. The study was underpinned by a feminist pragmatist theoretical framework and narrative methodology was used to collect professional stories of practice via self-written narratives and interviews. Through purposive and snowball sampling, a diverse sample in terms of age, years of experience, workplace settings and model of care they operated within, 45 NHS midwives from across the UK were recruited. Data were analysed using narrative thematic that generated four themes that described midwives’ processes of facilitating women’s alternative physiological births: 1. Relationship building, 2. Processes of support and facilitation, 3. Behind the scenes, 4. Birth facilitation. Collectively, the midwives were involved in a wide range of alternative birth choices across all birth settings. Fundamental to their practice was the development of mutually trusting relationships with the women which were strongly asserted a key component of safe care. The participants highlighted a wide range of personal and advanced clinical skills which was framed within an inherent desire to meet the women’s needs. Capturing what has been successfully achieved within institutionalised settings, specifically how, maternity providers may benefit from the findings of this study.

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“…3. Claire Feeley and Gill Thomson (2016), “Tensions and Conflicts in ‘Choice’: Womens’ Experiences of Freebirthing in the UK,” Midwifery , 41: 16–21.…”

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confidence: 99%

Exploring the conceptualisation and study of freebirthing as a historical and social phenomenon: a meta-narrative review of diverse research traditions

2020

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Freebirthing is a clandestine practice whereby women intentionally give birth without healthcare professionals (HCPs) present in countries where there are medical facilities available to assist them. Women who make this decision are frequently subjected to stigma and condemnation, yet research on the phenomenon suggests that women’s motivations are often complex. The aim of this review was to explore how freebirth has been conceptualised over time in the English-language academic and grey literature. The meta-narrative methodology employed enables a phenomenon to be understood within and between differing research traditions, as well as against its social and historical context. Our research uncovered nine research traditions (nursing, autobiographical text with birthing philosophy, midwifery, activism, medicine, sociology, law and ethics, pregnancy and birth advice, and anthropology) originating from eight countries and spanning the years 1957–2018. Most of the texts were written by women, with the majority being non-empirical. Empirical studies on freebirth were usually qualitative, although there were a small number of quantitative medical and midwifery studies; these texts often focused on women’s motivations and highlighted a range of reasons as to why a woman would decide to give birth without HCPs present. Motivations frequently related to women’s previous negative maternity experiences and the type of maternity care available, for example medicalised and hospital-based. The use of the meta-narrative methodology allowed the origins of freebirth in 1950s America to be traced to present-day empirical studies of the phenomenon. This highlighted how the subject and the publication of literature relating to freebirth are embedded within their social and historical contexts. From its very inception, freebirth aligns with the medicalisation of childbirth, the position of women in society, the provision of maternity care and the way in which women experience maternity services.

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Tensions and conflicts in ‘choice’: Womens’ experiences of freebirthing in the UK

Abstract: Abstract:2 Background: The concept of choice is a central tenet of modern maternity care. However,

Cited by 29 publications

References 30 publications

When the Hospital Is No Longer an Option: A Multiple Case Study of Defining Moments for Women Choosing Home Birth in High-Risk Pregnancies in The Netherlands

When the Hospital Is No Longer an Option: A Multiple Case Study of Defining Moments for Women Choosing Home Birth in High-Risk Pregnancies in The Netherlands

Understanding how midwives employed by the National Health Service facilitate women’s alternative birthing choices: Findings from a feminist pragmatist study

Exploring the conceptualisation and study of freebirthing as a historical and social phenomenon: a meta-narrative review of diverse research traditions

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