Do women’s ideas of ‘normal’ birth match those held by professionals? Abstract
Aim: To explore the definitions of normal birth held by women who have not given birth, what influences that perspective, and compare it with those of health professionals. Background: Available evidence provides conflicting definitions of normal childbirth. The majority of available evidence encapsulates the views of the health professionals themselves or women who have experienced childbirth. Little evidence exists that reflects the views of women yet to experience childbirth. Method: Six participants were identified via purposive sampling to undertake a small exploratory qualitative study utilizing semi-structured interviews and thematic analysis. Ethical approval was obtained. Results: The definition of normal birth is individual and complex. The absence of complications and use of interventions influenced this definition, which in part agrees with health professionals’ current definitions. Birth was perceived as a scary prospect; a view largely constructed from negative stories from friends and family. Conclusions: The findings suggest that working within the confines of a definition of ‘normal’ childbirth is far from straightforward. It highlights a need to encourage women to view birth more positively. Expanding this research further would explore these issues in more detail, providing more conclusive evidence to support practice. thinking to happen, both parties need to agree on what a ‘normal’ birth actually is. With these thoughts in mind, this research study set out to explore the understanding of normal birth held by women who have yet to experience birth, what influenced that understanding, and how closely their responses matched the range of definitions and ideas held by health professionals.
Childbirth is multidimensional and requires a definition that covers all aspects (Downe, 2006). However, differences of meaning are in use by various professions, and none of the definitions truly encapsulate all aspects of childbirth or provide a consistent definition (Gould, 2000). For some, childbirth without intervention is normal and optimal; for others, as long as the baby is born vaginally without assistance then this constitutes a normal birth. The term ‘normal childbirth’ has been used for decades as a way of differentiating between birth outcomes often for the purpose of producing statistical data. However, with continual scientific developments and an ever-changing society, the boundaries of what could be termed ‘normal’ have become blurred, particularly where interventions (and different degrees of interventions) are concerned. The World Health Organization (WHO) (1996) defined normal birth as: ‘Spontaneous in onset, low risk at the start of labour and remaining so throughout labour and delivery. The infant is born spontaneously in the vertex position, between 37 and 42 completed weeks of pregnancy. After birth mother and infant are in good condition’. Conversely, however—and only a year later— Beech (1997) argued that: ‘ the expectation that every pregnancy should end in a healthy mother and baby no matter what, has actually encouraged the justification for use of interventions’. British Journal of Midwifery • November 2011 • Vol 19, No 11
Alison Edwards Senior Lecturer in Midwifery, Birmingham City University Jacky Conduit Lecturer in Nursing and Physiotherapy, University of Birmingham
childbearing experience resulting in a healthy mother and baby is optimal. Finding agreement on the best way to achieve this, especially when considering the multifaceted nature of childbirth, is far more complex. Numerous articles and projects have shrouded childbirth in conflicting viewpoints and approaches, leaving even health professionals struggling to agree on a standard definition of normality. Childbirth has increasingly become the focus of reality TV shows, often cleverly edited to portray childbirth in...