Lead maternity carer midwives' construction of normal birth : a qualitative study : a thesis presented in fulfilment of the requirements for the degree of Master of Arts at Massey University

Abstract

Midwives provide maternity care for the majority of women in New Zealand and in 2000 midwives were the Lead Maternity Carer for seventy one percent of childbearing women. The aim of this research was to explore the assertion that continuity of midwifery care 'enhances and protects the normal process of childbirth' (New Zealand College of Midwives, 1993, p.7). I aimed to explore the meaning of 'normal birth' in Lead Maternity Care midwifery practice in the current New Zealand context and to understand the complex influences surrounding midwives' construction of normal birth. In order to explore the construction of 'normal birth' Lead Maternity Carer midwives were invited to participate in a small qualitative study. In-depth one to one interviews were used to collect data from nine Lead Maternity Carer midwives. Interviews were recorded, transcribed and analysed using thematic analysis. Using a qualitative approach allowed me to make thoughtful links with the literature and build upon what is already known about the construction of normal birth. Data analysis revealed that midwifery practice and women's birthing experiences occur in a contested context that remains firmly entrenched in a medically dominant model of care. There is an increasing normalisation of intervention and technology leading to ongoing medicalisation of the physiological processes of labour and birth. The midwives interviewed employed a number of strategies for promoting the normalcy of labour and birth including supporting women's choice to birth at home, and working with women in the hospital setting to birth without intervention. However, the medical model influenced the midwives' practice in a number of subtle ways and I argue that the medical model is the default mode: it is always there and is taken as the 'right' way to 'do' birth unless it is actively contended.