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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 examines symphysiotomy in twentieth-century Ireland as one example of a systematized obstetric violence that has characterized Ireland’s modern history. Expanding scholarly interpretations of state- and Church-inflicted abuse of women in the twentieth century, this analysis establishes the medical profession as a central actor alongside the twentieth-century state-Church coalition that regulated women’s reproductive lives and engaged in systematic repression. This chapter recognizes that Ireland’s history of reproductive abuse and coercion did not just involve contraception or abortion but also labor and birth experiences. In addition, it offers a more complete and complex interpretation of obstetric violence by highlighting the experiences of married women with wanted pregnancies; almost all research to date focuses on the experiences of unmarried pregnant women or unwanted pregnancies. This examination of symphysiotomy and obstetric violence in Ireland illuminates the ways in which religious, national, and medical power has been mapped on women’s reproductive bodies, particularly in the decades after independence in 1922. It also makes essential links between Ireland’s past and present, demonstrating that a careful analysis of the history of obstetric violence and the religious underpinnings of it are essential in understanding Ireland today. With this research, we also place symphysiotomy within the context of the global reproductive justice movement, asking how a reproductive justice framework – one that links reproductive rights with social justice – can help us interpret obstetric violence and address the wounds of Ireland’s past.

The purpose of this paper is to examine the association between experiences during childbirth and satisfaction with childbirth services.

A cross‐sectional analytical approach using a structured questionnaire and exit interviews was employed to gather data from 885 women who delivered vaginally in two public hospitals. Data were analysed by generating frequencies and chi‐square which was used in running a binary logistic regression using a stepwise backward elimination approach.

With a response rate of 78.75 percent the key predictor variables of satisfaction with care were: friendliness of staff (OR=15.12, p=0.00); the amount of information provided on the condition and treatment of women (OR=9.3857, p=0.007); the feeling of being treated with respect (OR=3.5581, p=0.023); and the provision of information about channels of complaint about care (OR=50.0839, p=0.000). It is therefore recommended that steps be instituted to improve client‐/health worker interpersonal relationships, to improve the amount and quality of information provided to clients, and also to establish formal structures for complaint management in hospitals.

The study sampled only women with vaginal deliveries, considering the fact that women with caesarean deliveries have different experiences. Thus views of those with caesarean deliveries are excluded.

Several studies have been conducted in Ghana on issues of health service satisfaction and quality, but this is about the first, critically looking at satisfaction with child birth services in Ghana.

Metaphor is an important concept for clean language interviewers. This chapter describes what metaphor is and overviews the experimental research showing the potential for metaphor to influence interviewees. It expands on the brief introduction to metaphor in Chapter 1 and describes the role clean language can play by enabling interviewees' metaphors to be elicited, explored and modelled without the influence of the interviewer's metaphors. It justifies the value of a heightened awareness of the ubiquity and variety of metaphors and their involvement in the different phases of qualitative research; and builds an argument for how a clean language interviewing approach to metaphor can enrich the research process.

As numerous scholars have noted, the law takes a strikingly incoherent approach to adolescent reproduction. States overwhelmingly allow a teenage girl to independently consent to pregnancy care and medical treatment for her child, and even to give up her child for adoption, all without notice to her parents, but require parental notice or consent for abortion. This chapter argues that this oft-noted contradiction in the law on teenage reproductive decision-making is in fact not as contradictory as it first appears. A closer look at the law’s apparently conflicting approaches to teenage abortion and teenage childbirth exposes common ground that scholars have overlooked. The chapter compares the full spectrum of minors’ reproductive rights and unmasks deep similarities in the law on adolescent reproduction – in particular an undercurrent of desire to punish (female) teenage sexuality, whether pregnant girls choose abortion or childbirth. It demonstrates that in practice, the law undermines adolescents’ reproductive rights, whichever path of pregnancy resolution they choose. At the same time that the law thwarts adolescents’ access to abortion care, it also fails to protect adolescents’ rights as parents. The analysis shows that these two superficially conflicting sets of rules in fact work in tandem to enforce a traditional gender script – that self-sacrificing mothers should give birth and give up their infants to better circumstances, no matter the emotional costs to themselves. This chapter also suggests novel policy solutions to the difficulties posed by adolescent reproduction by urging reforms that look to third parties other than parents or the State to better support adolescent decision-making relating to pregnancy and parenting.

There is extensive research documenting the physical outcomes of childbirth, but significantly less on socio-psychological outcomes. Investigating women’s perception of dignified treatment during birth contributes to a salient, under-examined aspect of women’s childbirth experiences.

We use a two-part conceptualization of dignity, respect and autonomy, to understand how birth experiences and interactions either facilitate or undermine women’s perceived dignity. Data came from the Listening-to-Mothers I survey, the first nationally representative study of postpartum women in the United States (n = 1,406). Through linear regression analysis, we separately modeled women’s perception of respectful treatment and women’s perception of medical autonomy during birth.

Overall women reported high scores for both autonomy and respect. Differences between the models emerged related primarily to the role of interventions and provider support. While women’s perceived dignity is related to elements that she brings in to the delivery room (e.g., birth knowledge, health status), much variation was explained by the medical encounter itself (e.g., type of medical interventions, pain management, nurse support, and number of staff present).

This study is cross-sectional, and required either a telephone or internet access, thus limiting the full generalizability of findings. Two findings have direct practical relevance for promoting women’s dignity in childbirth. First, the number of staff persons present during labor and birth was negatively associated with both respect and autonomy. Second, that women with high levels of knowledge about their legal rights during childbirth were more likely to report high scores on the dignity scale. Limiting staff in the delivery room and including knowledge of legal rights in childbirth education or during prenatal visits may be two mechanisms to promote dignity in birth.

These findings address an important, under-examined aspect of women’s childbirth experiences. This study investigates how different birth experiences and interactions either promote or violate childbearing women’s perception of dignity, and has significant implications for the provision of maternal healthcare. The results reinforce the importance of focusing on the socio-psychological dimensions of childbirth.

Purpose – This chapter briefly outlines the history of childbirth in the United States and describes the influence of the natural birth movement and consumer demand in shaping the contemporary advertising of mainstream maternity services.

Design/methodology/approach – Qualitative content analysis of 59 hospital websites was undertaken in order to understand how hospitals depict childbirth in their online advertising.

Findings – Our findings illustrate how contemporary medical institutions idealize childbirth through their depictions of its physical and social dimensions. Although hospital advertising has adopted some of the rhetoric of the natural birth movement in describing the social and symbolic dimensions of the childbirth experience, this rhetoric is shown to stand in tension to the highly rationalized and bureaucratic institutional nature of hospitals. These tensions are most apparent in advertised descriptions of the physical environment of maternity centers and in the attempt to depict hospitalized birth as an opportunity for the individual empowerment of women.

Research limitations/implications – This research is limited to an analysis of how providers advertise their services and does not provide data on whether practices actually reflect the rhetoric of the ideal birth. Future research should consider the fit between rhetoric and reality in hospital maternity practices in order to better understand the social structural constraints of delivering these services in a hospital maternity center.

Originality/value – This chapter highlights the importance of consumer demand for how maternity services are portrayed and identifies key tensions between an idealized image of birth and the rational, bureaucratic demands of modern medical institutions.

Turkish mothers’ interactions with medical authorities during pregnancy and childbirth have developed in a context of risk discourses produced by biomedical experts with surveillance justified by these discourses. Giving meaning to pregnancy and childbirth through the search for the reduction of risks is a reflexive part of Turkish mothers’ everyday life.

This research paper aims to discuss a study examining how pregnancy and childbirth are socially constructed, how increased medicalization is experienced by Turkish mothers, and how they assign meaning to pregnancy and childbirth. A phenomenological research was designed using depth interviews with 10 Turkish mothers with children aged 0–6 years, living in Istanbul who had high education and welfare levels.

The findings shed light on Turkish mothers’ subjective experiences and how medicine as a profession shapes these experiences. With the medicalization of pregnancy and childbirth, how the trust toward the experts, the knowledge of preparation for maternity in an appropriate and responsible manner have become functional for Turkish mothers to create a sense of ontological security are examined.