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The purpose of this paper is to describe what it is like to be a midwife in the professionally isolated and marginalised arena of home birth in Ireland and to explore whether the organisation of home birth services and professional discourse might be undermining the autonomy of home birth midwives.

This paper is drawn from auto-ethnographic field work, with 18 of the 21 self-employed community midwives (SECMs) offering home birth support to women in Ireland from 2006 to 2009. The data presented are derived from field notes of participant observations and from interviews digitally recorded in the field.

Home birth midwives must navigate isolated professional practice and negotiate when and how to interface with mainstream hospital services. The midwives talk of the dilemma of competing discourses about birth. Decisions to transfer to hospital in labour is fraught with concerns about the woman's and the midwife's autonomy. Hospital transfers crystallise midwives’ sense of professional vulnerability.

Maternity services organisation in Ireland commits virtually no resources to community midwifery. Home birth is almost entirely dependent upon a small number of SECMs. Although there is a “national home birth service”, it is not universally and equitably available, even to those deemed eligible. Furthermore, restrictions to the professional indemnification of home birth midwives, effectively criminalises midwives who would attend certain women. Home birth, already a marginal practice, is at real risk of becoming regulated out of existence.

This paper brings new insight into the experiences of midwives practicing at the contested boundaries of contemporary maternity services. It reveals the inappropriateness of a narrowly professional paradigm for midwifery. Disciplinary control of individuals by professions may countermand claimed “service” ideologies.

This paper aims to understand the maternal health vulnerabilities of migrant women in slums and explore their challenges during and after childbirth.

The study used a qualitative approach, including in-depth interviews through purposive and snowball sampling techniques. Thematic analysis was used for analysing data. The consolidated criteria for reporting qualitative studies (COREQ)-32 items were followed for reporting this study.

The study found that migrant women were highly susceptible to adverse birthing outcomes due to risks involved in birthing, lack of care and hygiene, lack of skilled care in dealing with complicated pregnancies and exposure to domestic and obstetric violence.

The study intends to highlight the narratives of female migrants’ birthing and maternal health challenges. The entire process of childbirth in slums with consequences can result in maternal and infant morbidities and mortalities.

This chapter at hand applies and extends Friedland and Alford's model of institutional logics to the case of birth practises focusing on a number of interrelated topics, namely, identity, trust, and ideology. It draws on Giddens's theory of modernity to “bring society back in,” as Friedland and Alford have formulated one major point of critique against existing institutional approaches. In its theoretical discussion, the chapter will focus on two issues: first, the treatment of conflict as a motor of institutional dynamics, and second, the relation between institutions and agency. The empirical data is based on participant observation, qualitative interviews with midwives and obstetricians, and a review of magazines and television material concerning birth and parenting.

Unassisted childbirth, also known as “freebirth,” is when a person intentionally gives birth at home with no professional birth attendant. The limited research on unassisted birth in the United States focuses on women’s reasons for making this choice. Studies suggest women are committed to birthing without a professional and that this choice is rooted in religious or natural-family belief systems. These studies do not adequately account for the ways a framework of “choice” obscures the role structural barriers play in decision-making processes. International research on unassisted childbirth finds that it is not always a first choice and may be a last resort for women who have had negative experiences with maternity care. More research on unassisted birth in the United States is needed to better understand if people face similar structural barriers. In this paper I examine how structural limitations of the US healthcare system intersect with values in decision-making processes about childbirth. Drawing on in-depth interviews with nine women who gave birth unassisted in the United States, I examine the women’s shared ideological commitments, negative experiences with health care, and barriers faced seeking care. I discovered that unassisted birth may not be a first, or even positive choice, but rather a compromise informed by ideological commitments and constrained choices. Structural barriers in the US healthcare system prevented women from having a professional birth attendant who they felt was acceptable, available, and accessible. I conclude by discussing the implications of these findings for debates about birth justice and health policy.

This chapter is concerned with the varied legitimizing discourses used by midwives to frame their identities in relation to their work. This sociological issue is particularly important in the context of an occupation, such as this one, that exists at the border of competing service claims. Drawing on 26 in-depth interviews, I use narrative analysis to examine the stories that midwives tell about their work. Through these women’s work narratives, I show the complex intersection of narrative, culture, institution, and biography (Chase, 1995, 2001; DeVault, 1999).

Language is a fundamental and yet extraordinarily powerful medium. Language is more than the primary feature distinguishing humans from other species. As our principle means of communication, language links us to culture, and in so doing, shapes our perceptions and determines the way in which we think (Clark, Eschholz & Rosa, 1981; Thorne, Kramarae & Henley, 1983). Language is inseparable from social life. Through language, individuals learn cultural patterns and political and social values (Mueller, 1973). Language also reflects the prejudices of society, with assumptions about relative status, power or appropriate behavior often built into the words we use to talk about different groups of people. As Frank and Anshen (1983) note, ageism, racism, and most importantly for this discussion, sexism, are all perpetuated by our language, even among those who consciously reject those prejudices.

Servicescape is well recognized by marketing scholars as a key influence in transformative service outcomes. However, the concept of enabling transformative health outcomes through physical servicescape design is often overlooked. The purpose of this study is to integrate marketing's servicescape research with birth territory theory and the enabling places framework, conceptualizing a Co-Curated Transformative Place (CCTP) framework.

This cross-disciplinary conceptual paper uses three places of birth (POB) servicescapes for low-risk birthing women to ground the CCTP framework.

Positioned within transformative service research, this study shows how POB servicescapes are CCTPs. The organizing framework of CCTP comprises four key steps founded on agile and adaptive co-curation of physical place resources.

This study extends the servicescape conceptualization to incorporate the continuum of terrain, introducing adaptive and agile co-curation of places.

The materiality of place and physical resources in CCTP are usefully understood in terms of co-curated substantive staging according to service actor needs. The CCTP servicescape maximizes desired value outcomes and quality experience by adaptive response to service demands and service actors’ needs.

Theoretical discourse of health servicescapes is expanded to focus on the material components of place and their foundational role in generating resources and capabilities that facilitate the realization of service value. In the CCTP, service actors flexibly select, present and adapt physical artifacts and material resources of the service terrain according to dynamic actor needs and service responsibilities, enabling transformative outcomes. Co-curation facilitates reciprocal synergy between other dimensions of place and servicescape.

The purpose of this paper is to advocate for improved service delivery of maternal-newborn care in northern Indigenous communities. This is done through critical examination of the loss of pregnancy and birthing knowledge and practice in these communities, from both a historical and contemporary lens. Supporting the return of traditional midwifery practices to the communities is the recommended solution.

The paper is a general review of the available literature regarding Indigenous birthing practices, historical and contemporary Canadian maternal health service provision, and midwifery.

Current maternal health care practice in these northern communities is not resolving service delivery and human resource inadequacies, highlighting the need for a community-based and midwifery-driven primary health care approach. Potential recommendations include implementing a comprehensive birthing initiative, innovative midwifery training, and promotion and support of the role of the community midwife.

“Lost births” is a largely unrecognized issue in Canadian public health literature. The value of this paper lies in its potential to stimulate discourse and advocacy.

The aim of this study was to explore the reasons for preferring home as a birth delivery place and identify the socio-economic and cultural factors influencing the choice of delivery place in rural Bangladesh.

The data for the study come from a community-based cross-sectional study conducted among 464 mothers in a rural sub-district of Bangladesh in 2019. Respondents were selected randomly from the frame listing all mothers with inclusion criteria, using a two-stage cluster sampling design. Data were collected through a face-to-face interview. Both descriptive and inferential statistics and logistic regression models were used for data analysis.

The results indicate a very high rate (58%) of home delivery. About 20% mothers never received ANC visit. Preference for home delivery was high (63%). Mothers with no education, aged 30 and above, multi-parity, low wealth status, lack of knowledge about institutional delivery, no or <4 ANC visits, received no advice about the delivery place, no pregnancy complications, decision about health care, and prior plan for home delivery were identified as significant predictors of home delivery. Cost of services, cultural practices and attitude towards health facility, lack of a female delivery assistant, perceived fear of caesarian section, poor quality of services, and lack of knowledge about maternity services appeared as important barriers for institutional delivery.

Based on primary data from a rural area, this study would help understand reasons and factors affecting home delivery and developing an appropriate strategy for the improvement of institutional delivery and maternity care services in Bangladesh.

The purpose of this paper is to develop a psychometric scale – the birth satisfaction scale (BSS) – for assessing women's birth perceptions.

Literature review and transcribed research‐based perceived birth satisfaction and dissatisfaction expression statements were converted into a scored questionnaire.

Three overarching themes were identified: service provision (home assessment, birth environment, support, relationships with health care professionals); personal attributes (ability to cope during labour, feeling in control, childbirth preparation, relationship with baby); and stress experienced during labour (distress, obstetric injuries, receiving sufficient medical care, obstetric intervention, pain, long labour and baby's health).

Women construct their birth experience differently. Views are directed by personal beliefs, reactions, emotions and reflections, which alter in relation to mood, humour, disposition, frame of mind and company kept. Nevertheless, healthcare professionals can use BSS to assess women's birth satisfaction and dissatisfaction. Scores measure their service quality experiences.

Scores provide a global measure of care that women perceived they received during labour.

Finding out more about what causes birth satisfaction and dissatisfaction helps maternity care professionals improve intra‐natal care standards and allocate resources effectively. An attempt has been made to capture birth satisfaction's generalised meaning and incorporate it into an evidence‐based measuring tool.