Me aro ki te ha o hineahuone : women, miscarriage stories, and midwifery : towards a contextually relevant research methodology : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Midwifery at Massey University, Palmerston North, New Zealand

Abstract

Professional ethics and legal competencies require midwives practising in New Zealand to provide care for childbearing women in a partnership characterised by continuity, equality, mutual respect, trust, shared responsibility and decision making. New Zealand is culturally and legislatively a bi-cultural environment and the cultural safety of Maori (indigenous peoples) are prioritised within health legislation. The midwifery philosophy of partnership and bi-cultural legislation, have provided a foundation for developing a research methodology for the profession. This thesis stories the interweaving of multiple epistemologies, theoretical tenets, philosophical concepts, indigenous and Western European world views as well as women’s narratives in creating and implementing a contextually relevant qualitative research methodology, ‘Te Whakamaramtanga’. The methodology was trialled in the field of miscarriage; a practice issue for midwives in New Zealand. Research participants were recruited through ‘word of mouth’ and snowballing methods. Twenty women participated in the research project and of these nine identified as midwives. Twelve participants were of Non Maori descent, including four women who were immigrants to New Zealand, and eight participants identified as Maori. Participants’ stories were gathered through dialogical interviews, which recognised the co-construction and exploration of knowledge. Ethical tenets outlined in the methodology involved the use of extensive, ongoing consultation with Maori, midwifery and local communities. Maori, women, and midwives share an oral culture that values narratives as facilitating the constitution of identities, creation and transmission of knowledge, and the development of social relationships. Whole narrative, thematic and narrative elements analyses of participants’ miscarriage-related talk have been developed through drawing on kaupapa Maori philosophy, the social theories of Pierre Bourdieu, Michel Foucault, Bruno Latour, Paul Ricouer, and Rom Harre as well as the narrative concepts of Arthur Frank and Margaret Somers. Substantive chapters explore whakapapa, corporeal temporalities, narrative silences and women’s desires for recognition and relationships. A new theory is advanced that methodologies, narratives, genealogies, temporalities, silences and women voices are simultaneously co-constituted metaphysical and material technologies. These heterogeneous and relational entities are collectively perceived as actants, hybrid actors, actor networks as well as technologies, which exist within a range of dynamic and hierarchical networks and/or fields in which this thesis is also embedded. My development of a multicultural midwifery research methodology informed by multidisciplinary theoretical approaches is innovative for midwifery research and theory, and potentially other health disciplines. My research also addresses gaps in midwifery, miscarriage–related, professional development, Maori health and health research literature.