‘It's your body, but…’ Mixed messages in childbirth education: Findings from a hospital ethnography

Newnham, Elizabeth; McKellar, Lois; Pincombe, Jan

Abstract

Objective
to investigate the personal, social, cultural and institutional influences on women making decisions about using epidural analgesia in labour. In this article we discuss the findings that describe practices around the gaining of consent for an epidural in labour, which we juxtapose with similar processes relating to use of water for labour and/or birth.

Design
ethnography.

Setting
tertiary hospital in Australian city.

Participants
sequential interviews were conducted with 16 women; hospital staff (primarily midwives and doctors) participated during six months of participatory observation fieldwork.

Findings
women were not given full disclosure of either practice and midwives tailored the information they gave according to the institutional policies rather than evidence.

Key conclusions
informed consent is an oft-cited human right in health care, yet in maternity care the micro-politics of how informed consent is gained is difficult to ascertain, leading to a situation whereby the concept of informed consent is more robust than the reality of practice; an illusion of informed consent exists, yet information is often biased towards medicalised birth practices.

Implications for practice
as primary maternity care-givers, midwives have a role in providing unbiased information to women; however it appears that hospital culture and policy affect the way that this information is presented. It is arguable whether women in such instances are giving true informed consent, and for this reason, the ethics of these hidden practices are questioned.

Citation

Newnham, E., McKellar, L., & Pincombe, J. (2017). ‘It's your body, but…’ Mixed messages in childbirth education: Findings from a hospital ethnography. Midwifery, 55, 53-59. https://doi.org/10.1016/j.midw.2017.09.003

• Journal Article Type: Article
• Acceptance Date: Sep 8, 2017
• Online Publication Date: Sep 11, 2017
• Publication Date: 2017-12
• Deposit Date: Sep 14, 2022
• Journal: Midwifery
• Print ISSN: 0266-6138
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 55
• Pages: 53-59
• DOI: https://doi.org/10.1016/j.midw.2017.09.003
• Keywords: Antenatal education, Bioethics, Epidural analgesia, Informed consent, Midwifery, Water immersion
• Public URL: http://researchrepository.napier.ac.uk/Output/2898125