Resistance and Relearning: Women’s Experiences Choosing Midwifery and Home Birth in Ontario, Canada
DOI:
https://doi.org/10.56105/cjsae.v27i3.3902Keywords:
Adult Learning, Midwifery, Home Birth, Women's Childbirth Decision-Making, Women's HealthAbstract
Using a critical feminist approach, and with attention to participants’ broad life experiences, this qualitative study explores seven women’s learning in their challenging, transformative decisions to give birth at home with midwives in Ontario, Canada. Semi-structured interviews were conducted with women who had recently planned midwife-attended home births to shed light on how they learned about these childbirth possibilities and gained the confidence to plan a home birth. Participants’ narratives revealed that to make these choices, they had to become active and informed decision-makers, and resist the dominant view of birth as inherently risky, and of women’s birth experiences as unimportant and incompatible with the birth of a healthy baby. Replacing myths and misconceptions about midwifery, and especially about home birth, with more current and evidence-based information was critical to participants’ resistance and relearning, as were their own life experiences and those of women they trusted.
References
References
Association of Ontario Midwives. (2010). Choice of birthplace. Retrieved from
Association of Ontario Midwives. (2011). Vaginal birth after one previous low-segment caesarean section. Clinical practice guideline (No. 14). Retrieved from
Association of Ontario Midwives. (n.d.). Midwifery care: At home. Retrieved from
http://www.ontariomidwives.ca/care/birth/home
Association of Ontario Midwives. (n.d.). News room: FAQ. Retrieved from http://www.ontariomidwives.ca/news-room/kit/faq
Biggs, L. (2004). Rethinking the history of midwifery in Canada. In I. L. Bourgeault, C. Benoit, and R. Davis-Floyd (Eds.), Reconceiving midwifery (17-45). Montreal, QC and Kingston, ON: McGill-Queen’s University Press.
BORN (Better Outcomes Registry & Network) Ontario. (2013). Provincial overview of perinatal health 2011–2012 [PowerPoint slides]. Retrieved from https://www.bornontario.ca/en/resources/reports/lhin-regional-reports/
Boucher, D., Bennett, C., McFarlin, B., & Freeze, R. (2009). Staying home to give birth: Why women in the United States choose home birth. Journal of Midwifery & Women’s Health, 54, 119-126.
Bourgeault, I. L. (2006). Push! The struggle for midwifery in Ontario. Montreal, QC and Kingston, ON: McGill-Queen’s University Press.
Burtch, B. (1994). Trials of labour: The re-emergence of midwifery. Montreal, QC and Kingston, ON: McGill-Queen’s University Press.
Burton, N. & Ariss, R. (2009). The critical social voice of midwifery: Midwives in Ontario. The Canadian Journal of Midwifery Research and Practice, 8(1). 7-22.
Catling-Paull, C., Dahlen, H., & Homer, C. (2011). Multiparous women’s confidence to have a publicly-funded homebirth: A qualitative study. Women & Birth, 24, 122-128.
Cheyney, M. J. (2008). Homebirth as systems-challenging praxis: Knowledge, power, and intimacy in the birthplace. Qualitative Health Research, 18(2), 254-267.
College of Midwives of Ontario. (2014). The Ontario midwifery model of care. Retrieved from http://www.cmo.on.ca/?page_id=429
Dahlen, H. (2010). Undone by fear? Deluded by trust? Midwifery, 26, 156-162.
Darling, L., & Gagnon, G. (2013). Midwifery-led birth centres in Ontario: A new option for families. BORN Provincial Rounds [PowerPoint slides]. Retrieved from http://www.bornontario.ca/assets/documents/provincialrounds/Midwifery%20led%20Birth%20Centers%20in%20Ontario-%20June%202013.pdf
Davidson, H. A. (1997). Territoriality among health care workers: Opinions of nurses and doctors toward midwives (Unpublished doctoral dissertation). University of Toronto, Toronto, Ontario.
Davis-Floyd, R. E., Barclay, L., Daviss, B., & Tritten, J. (2009). Conclusion. In R.E. Davis-Floyd, L. Barclay, B. Daviss, & J. Tritten (Eds.). Birth models that work (441-460). Los Angeles, CA: University of California Press.
Daviss, B. A. (2001). Reforming birth and (re)making midwifery in North America. In R. DeVries, C. Benoit, E. R. Van Teilingen, & S. Wrede (Eds.), Birth by design: Pregnancy, maternity care, and midwifery in North America and Europe (70-86). New York, NY: Routledge.
Declercq, E., DeVries, R., Viisainen, K., Salvesen, H. B., & Wrede, S. (2001). Where to give birth? Politics and the place of birth. In R. DeVries, C. Benoit, E. R. Van Teilingen, & S. Wrede (Eds.), Birth by design: Pregnancy, maternity care, and midwifery in North America and Europe (7-27). New York, NY: Routledge.
De Jonge, A., van der Goes, B. Y., Ravelli, A. C. J., Amelink-Verburg, M. P., Mol, B. W., Nijhuis, J. G., Bennebroek Gravenhorst, E., & Buitendijk, S. E. (2009). Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births. British Journal of Obstetrics and Gynaecology, 116(9), 1177-1184.
Dreger, A. (2012, March 20). The most scientific birth is often the least technological birth. The Atlantic. Retrieved from http://www.theatlantic.com/health/archive/2012/03/the-most-scientific-birth-is-often-the-least-technological-birth/254420/
Ehrenreich, B., & English, D. (1973/2010). Witches, midwives & nurses: A history of women healers (2nd ed.). New York, NY: The Feminist Press.
Ford, A. R., & Van Wagner, V. (2004). Access to midwifery: Reflections on the Ontario equity committee experience. In I. L. Bourgeault, C. Benoit, and R. Davis-Floyd (Eds.), Reconceiving midwifery (244-262). Montreal, QC and Kingston, ON: McGill-Queen’s University Press.
Godfrey, M. K. (2010). Influential factors for first-time mothers in their decision making processes in planning their home births (Unpublished doctoral dissertation). Colorado State University, Fort Collins, CO.
Harding, S. (1987). Introduction. In S. Harding (Ed.). Feminism and methodology (1-14). Bloomington, IN: Indiana University Press.
Hutton, E. K., Reitmsa, A. H., & Kaufman, K. (2009). Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: A retrospective cohort study. Birth, 36(3), 180-189.
Janssen, P. A., Saxell, L., Page, L. A., Klein, M. C., Liston, R. M., Lee, S. K. (2009b). Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. Canadian Medical Association Journal, 181(6-7), 377-383.
Jordan, B. (1997). Authoritative knowledge and its construction. In R. Davis-Floyd and C. Sargent (Eds.), Authoritative knowledge in childbirth: Cross-cultural perspectives (55-79), Berkeley and Los Angeles, CA: University of California Press.
Kennedy, H. P. Nardini, K., McLeod-Waldo, R., & Ennis, L. (2009). Top-selling childbirth advice books: A discourse analysis. Birth, 36(4), 318-324.
Klassen, P. (2001). Blessed events: Religion and home birth in America. Princeton, NJ: Princeton University Press.
Klein, M. C., Liston, R. Fraser, W. D., Baradaran, N., Hearps, S. J. C., Tomkinson, J., Kaczorowki, J., & The Maternity Care Research Group. (2011). Attitudes of the new generation of obstetricians: How do they differ from their predecessors? Birth, 38(2), 129-139.
Klein, M., Sakala, J., Simkin, P., Davis-Floyd, R., Rooks, J., & Pincus, J. (2006). Roundtable: Why do women go along with this stuff? Birth, 33(3), 245-250.
Kornelson, J. & Carty, E. (2004). Challenges to midwifery integration: Interprofessional relationships in British Columbia. In I. L. Bourgeault, C. Benoit, & R. Davis-Floyd (Eds.), Reconceiving midwifery (111-130). Montreal, QC and Kingston, ON: McGill-Queen’s University Press.
Kotaska, A. (2009). Breech birth can be safe, but is it worth it? Journal of Obstetrics and Gynaecology Canada, 31(6), 553-554.
Liva, S. J., Hall, W. A., Klein, M. C., & Wong, S. T. (2012). Factors associated with Canadian perinatal care nurses’ attitudes toward birth practices. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41, 761-773.
MacDonald, M. E. (2004). Tradition as a political symbol in the new midwifery in Canada. In I. L. Bourgeault, C. Benoit, and R. Davis-Floyd (Eds.), Reconceiving midwifery (46-66), Montreal, QC and Kingston, ON: McGill-Queen’s University Press.
MacDonald, M. E. (2007). At work in the field of birth: midwifery narratives of nature, tradition, and home. Nashville, TN: Vanderbilt University Press.
Martin, E (1987/1992/2001). The woman in the body: A cultural analysis of childbirth. Boston, MA: Beacon Press.
Murray-Davis, B., McDonald, H., Reitsma, A., Coubrough, M., & Hutton, E. (2014). Deciding on home or hospital birth: Results of the Ontario choice of birthplace survey. Midwifery, 30, 869-876.
Murray-Davis, B., McNiven, P., McDonald, H., Malott, A., Elahar, L., & Hutton, E. (2012). Why home birth? A qualitative study exploring women’s decision making about place of birth in two Canadian provinces. Midwifery, 28, 576-581.
Olsen, O. (1997). Meta-analysis of the safety of home birth. Birth, 24(1): 4-13.
Pincus, J. (2000). Childbirth advice literature as it relates to two childbearing ideologies. Birth, 27(3), 209-213.
Renfrew, M. J., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N. F… Declercq, E. (2014). Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care. The Lancet. Retrieved from
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60789-3/abstract
Rothman, B. K. (1989). Recreating motherhood: Ideology and technology in a patriarchal society. New York, NY and London, UK: W.W. Norton & Company.
Rushing, B. (1993). Ideology and the reemergence of North American midwifery. Work and Occupations, 20(1), 46-67.
Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2013). Midwife-led continuity models versus other models of care for childbearing women. The Cochrane database of systematic reviews, Issue 8. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub3.
Sharpe, M. J. D. (2004). Intimate business: Woman-midwife relationships in Ontario, Canada (Unpublished doctoral dissertation). University of Toronto. Toronto, Ontario.
Sharpe, M., & Gold, L. (2011). Midwife-led home birth in Ontario: Maintaining confidence and competence: Facts, issues, dilemmas and possible strategies. (Unpublished research).
Smith, D. E. (1990). The conceptual practices of power: A feminist sociology of knowledge. Toronto, ON: University of Toronto Press.
Van Wagner, V. (1992). Women organizing for midwifery in Ontario. Resources for Feminist Research, 17(3), 115-118.
Van Wagner, V. (2004). Why legislation?: Using regulation to strengthen midwifery. In I. L. Bourgeault, C. Benoit, & R. Davis-Floyd (Eds.), Reconceiving midwifery (71-90). Montreal, QC and Kingston, ON: McGill-Queen’s University Press.
Vedam, S., Stoll, K., Schummers, L., Fairbrother, N., Klein, M. C., Thordarson, D., Kornelsen, J., … Kaczorowski, J. (2014). The Canadian birth place study: Examining maternity care provider attitudes and interprofessional conflict around planned home birth. BMC Pregnancy and Childbirth, 14(353).
Witz, A. (1992). Professions and patriarchy. London, UK and New York, NY: Routledge.
Young, I. M. (1990). Pregnant embodiment: Subjectivity and alienation. In I. M. Young (Ed.), Throwing like a girl and other essays in feminist philosophy and social theory, (160-174). Bloomington, IN: Indiana University Press.
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