Midwifery Practice During Birth: rites of passage and rites of protection
I completed my PhD in 2013. My aim was to contribute to an understanding of birth, and midwifery practice, grounded in women’s experience.
The full thesis is available in the USC Research Bank and has been downloaded over 5700 times. I have published the findings of my research in journal articles and conference papers. I have also been invited to speak about the childbirth rite of passage at many events. My latest book Reclaiming Childbirth as a Rite of Passage applies the findings of my PhD to the modern context of birth.
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 the findings
Dr Rachel Reed