Place of Birth and Concepts of Wellbeing: An Analysis from Two Ethnographic Studies of Midwifery Units in England

Article


McCourt, Christine, Rayment, Juliet, Rance, S. and Sandall, Jane 2016. Place of Birth and Concepts of Wellbeing: An Analysis from Two Ethnographic Studies of Midwifery Units in England. Anthropology in Action. 23 (3), pp. 17-29.
AuthorsMcCourt, Christine, Rayment, Juliet, Rance, S. and Sandall, Jane
Abstract

This article is based on analysis of a series of ethnographic case studies of midwifery Units in England. Midwifery units are spaces that were developed to provide more home-like and less medically oriented care for birth that would support physiological processes of labour, women’s comfort and a positive experience of birth for women and their families. They are run by midwives, either on a hospital site alongside an obstetric unit (Alongside Midwifery Unit – AMU) or a freestanding unit away from an obstetric unit (Freestanding Midwifery Unit – FMU). Midwifery units have been designed and intended specifically as locations of wellbeing and although the meaning of the term is used very loosely in public discourse, this claim is supported by a large epidemiological study, which found that they provide safe care for babies while reducing use of medical interventions and with better health outcomes for the women. Our research indicated that midwifery units function as a protected space, one which uses domestic features as metaphors of home in order to promote a sense of wellbeing and to re-normalise concepts of birth, which had become inhabited by medical models and a preoccupation with risk. However, we argue that this protected space has a function for midwives as well as for birthing women. Midwifery units are intended to support midwives’ wellbeing following decades of professional struggles to maintain autonomy, midwife-led care and a professional identity founded on supporting normal, healthy birth. This development, which is focused on place of birth rather than other aspects of maternity care such as continuity, shows potential for restoring wellbeing on individual, professional and community levels, through improving rates of normal physiological birth and improving experiences of providing and receiving care. Nevertheless, this very focus also poses challenges for health service providers attempting to provide a ‘social model of care’ within an institutional context.

Keywordsbirth centre; birthplace; childbirth; England; maternity care; midwife-led care; midwifery units; organisational ethnography; place; wellbeing
JournalAnthropology in Action
Journal citation23 (3), pp. 17-29
ISSN1752-2285
0967-201X
Year2016
PublisherBerghahn Journals
Accepted author manuscript
License
CC BY-NC-ND
Digital Object Identifier (DOI)doi:10.3167/aia.2016.230303
Web address (URL)http://www.berghahnjournals.com/view/journals/aia/23/3/aia230303.xml
Publication dates
Print01 Dec 2016
Publication process dates
Deposited13 Jan 2017
Accepted14 Apr 2016
FunderNational Institute for Health Research
National Institute for Health Research
Department of Health
King’s College Hospital NHS Foundation Trust
Copyright information© 2016 Berghahn Books and the Association for Anthropology in Action
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