Finally I have completed my Phd! It took me six years – the last two mostly writing… and writing… and rewriting. Entire chapters did not make the final ‘cut’. There is so much more I wanted to say (and did) about authoritative knowledge and the ritual nature of midwifery practice. Hopefully I will share this work another way in the future.

My aim was to contribute to an understanding of birth, and midwifery practice, grounded in women’s experience. I believe we need to develop (reclaim) our own birth knowledge in order to shift the current medical paradigm that is failing women.

The Phd journey has been a rite of passage itself, and I pushed myself to my edge and beyond. I thought about giving up at times, and felt self-doubt about my ability (I left high school with no qualifications and a baby in my belly). I accepted my fears and kept going one step at a time. In the process, I learned not only about my topic, research, and writing; but also about myself.

The abstract is posted below, and you can download the full thesis here. I’d welcome comments, questions and discussion about the research.

There are two published journal articles available from this study (apologies they are not open access):

• Reed, R, Barnes, M & Rowe, J 2016 ‘Women’s experience of birth: childbirth as a rite of passage’ International Journal of Childbirth, vol. 6, no. 1, pp.46-56.
• Reed, R, Rowe, J & Barnes, M 2016 ‘Midwifery practice during birth: ritual companionship’ Women and Birth, vol. 29, no. 3, pp. 269-278.

Big THANKS to the participants – mothers and midwives – who generously shared their birth stories.

Abstract

This study explored midwifery practice during birth. In particular, the experiences, actions and interactions between midwives and women during uncomplicated, normal births.

Most of the existing literature focuses on outcomes associated with individual practices; and there is a lack of research evidence supporting many of the common midwifery practices carried out during birth. There is also limited research exploring midwives’ experiences and perceptions of their practice during birth; although it seems that the context of midwifery practice, and cultural norms influence practice. Studies exploring women’s experience of birth have identified an altered state of consciousness, and issues of control as key factors. However, there has been very little research specifically examining women’s experience of midwifery practice during birth. This study sought to explore the experience of midwifery practice from both the perspective of the midwife and the woman.

The study is a narrative inquiry, and a feminist approach was taken throughout the research process. Birth stories were gathered from mothers and midwives during in-depth interviews. The participants had either experienced or attended an uncomplicated vaginal birth, and were encouraged to share their story of this experience. Narratives were created from the interview transcripts and analysed to identify common themes. An explanatory framework ‘rites of passage’ was then applied to further illuminate the narrative of midwifery practice during birth.

The findings are presented in three chapters. The first focuses on the mothers’ experiences of birth as a rite of passage. This chapter provides the foundation for the following chapters that present midwifery practice during birth. Midwives enacted ‘rites of passage’ during birth that tended the boundaries of aloneness, and nurtured self-trust and inner wisdom. Midwives also enacted ‘rites of protection’ which contradicted rites of passage, but tended the needs of the institution. Tensions arose between these two types of rites, and conflicting cultural values were transmitted and reflected through their performance.

Findings are discussed in relation to the literature, and the thesis concludes with recommendations for midwifery practice, midwifery education, and further research. Recommendations centre on a model of midwifery practice as ‘ritual companionship’ as the basis for developing midwifery practices that are aligned with women’s experience of birth.

Conceptual map of findings